Next Article in Journal
Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
Previous Article in Journal
A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract
 
 
Article

The Clinical Significance of the Hyperintense Acute Reperfusion Marker Sign in Subacute Infarction Patients

1
Department of Medicine, Graduate School, Kyung Hee University, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
2
Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
3
Department of Neurology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
*
Author to whom correspondence should be addressed.
Academic Editor: Sophie Mavrogeni
Diagnostics 2021, 11(11), 2161; https://doi.org/10.3390/diagnostics11112161
Received: 29 September 2021 / Revised: 15 November 2021 / Accepted: 17 November 2021 / Published: 22 November 2021
(This article belongs to the Section Medical Imaging and Theranostics)
Purpose: The hyperintense acute reperfusion marker (HARM) is characterized by the delayed enhancement of the subarachnoid or subpial space observed on postcontrast fluid-attenuated inversion recovery (FLAIR) images, and is considered a cerebral reperfusion marker for various brain disorders, including infarction. In this study, we evaluated the cerebral distribution patterns of HARM for discriminating between an enhancing subacute infarction and an enhancing mass located in the cortex and subcortical white matter. Materials and methods: We analyzed consecutive patients who experienced a subacute ischemic stroke, were hospitalized, and underwent conventional brain magnetic resonance imaging including postcontrast FLAIR within 14 days from symptom onset, as well as those who had lesions corresponding to a clinical sign detected by diffusion-weighted imaging and postcontrast T1-weighted imaging between May 2019 and May 2021. A total of 199 patients were included in the study. Of them, 94 were finally included in the subacute infarction group. During the same period, 76 enhancing masses located in the cortex or subcortical white matter, which were subcategorized as metastasis, malignant glioma, and lymphoma, were analyzed. We analyzed the overall incidence of HARM in subacute ischemic stroke cases, and compared the enhancement patterns between cortical infarctions and cortical masses. Results: Among 94 patients with subacute stroke, 78 patients (83%) presented HARM, and among 76 patients with subcortical masses, 48 patients (63%) presented peripheral rim enhancement. Of 170 subcortical enhancing lesions, 88 (51.8%) showed HARM, and 78 (88.6%) were determined to be subacute infarction. Among 94 patients with subacute stroke, 48 patients (51%) had diffusion restrictions, and HARM was found in 39 patients (81.2%). Of the 46 patients (49%) without diffusion restriction, 39 patients (84.8%) showed HARM. Conclusions: The presence of HARM was significantly associated with subacute infarctions. For the masses, a peripheral rim enhancement pattern was observed around the mass rather than the cerebral sulci on postcontrast FLAIR. View Full-Text
Keywords: subacute infarction; postcontrast FLAIR; HARM sign; ischemia subacute infarction; postcontrast FLAIR; HARM sign; ischemia
Show Figures

Figure 1

MDPI and ACS Style

Lee, J.Y.; Lee, K.M.; Kim, H.-G.; Woo, H.-G.; Lee, J.S.; Kim, E.J. The Clinical Significance of the Hyperintense Acute Reperfusion Marker Sign in Subacute Infarction Patients. Diagnostics 2021, 11, 2161. https://doi.org/10.3390/diagnostics11112161

AMA Style

Lee JY, Lee KM, Kim H-G, Woo H-G, Lee JS, Kim EJ. The Clinical Significance of the Hyperintense Acute Reperfusion Marker Sign in Subacute Infarction Patients. Diagnostics. 2021; 11(11):2161. https://doi.org/10.3390/diagnostics11112161

Chicago/Turabian Style

Lee, Ji Young, Kyung Mi Lee, Hyug-Gi Kim, Ho-Geol Woo, Jin San Lee, and Eui Jong Kim. 2021. "The Clinical Significance of the Hyperintense Acute Reperfusion Marker Sign in Subacute Infarction Patients" Diagnostics 11, no. 11: 2161. https://doi.org/10.3390/diagnostics11112161

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop