MRI quantitative T2* mapping on thrombus to predict recanalization after endovascular treatment for acute anterior ischemic stroke

R. Bourcier , N. Brecheteau , V. Costalat (1) , B. Daumas-Duport , B. Guyomarch-Delasalle , Hubert Desal (2) , O. Naggara , J. M. Serfaty

1 Département de Neuroradiologie[Montpellier]
2 CHU Nantes - Centre Hospitalier Universitaire de Nantes

In anterior acute ischemic stroke (AAIS) treated with endovascular treatment (EVT), the susceptibility vessel sign (SVS+ or SVS-) is related to recanalization results (TICI 2b/3) and clinical outcome. However, a binary qualitative assessment of thrombus using SVS does not reflect its complex composition. Our aim was to assess whether a quantitative MRI marker, Thrombus-T2* relaxation time, may be assessable in clinical routine and may to predict early successful recanalization after EVT, defined as a TICI 2b/3 recanalization obtained in 2 attempts or less. MATERIAL AND METHODS: Thrombus-T2* relaxation time was prospectively obtained from consecutive AAIS patients treated by EVT (concomitant aspiration and stent retriever). Quantitative values were compared between early recanalization and late or unsuccessful recanalization. RESULTS: Thirty patients with AAIS were included and Thrombus-T2* relaxation time was obtained in all patients. Earlier TICI 2b/3 recanalization were obtained in 22 patients (73%) and was significantly associated with SVS+ (1/8 vs. 16/22, P=0.01) and a shorter Thombus-T2* relaxation time (mean SD, range: 257, 18-50ms vs. 45 9, 35-60ms, P\textless0.001). CONCLUSION: A new quantitative MRI biomarker, the Thrombus-T2* relaxation time is assessable in clinical routine. In a preliminary study of 30 patients, a shorter Thombus-T2* relaxation time is related to earlier recanalization after EVT using combination of stent retriever and aspiration.

Mots clés: Humans; Female; Male; Retrospective Studies; Stroke; Adult; Aged; Middle Aged; Treatment Outcome; 80 and over; Brain Ischemia; Thrombectomy; Brain Mapping; Endovascular Procedures; Magnetic Resonance Imaging; Stents; Cerebral Angiography; Cerebral Revascularization; Mapping; Quantitative; Suction; T2*; Thrombosis; Thrombus

Domaines: Sciences du Vivant [q-bio]

R. Bourcier, N. Brecheteau, V. Costalat, B. Daumas-Duport, B. Guyomarch-Delasalle, et al.. MRI quantitative T2* mapping on thrombus to predict recanalization after endovascular treatment for acute anterior ischemic stroke. Journal de Neuroradiologie / Journal of Neuroradiology, 2017, 44 (4), pp.241--246. ⟨10.1016/j.neurad.2017.03.006⟩. ⟨hal-01761877⟩