Prognostic value of deep medullary vein signs on magnetic sensitive weighted imaging in acute anterior circulation cerebral infarction

Objective To investigate the correlations of distribution and grading of deep medullary veins (DMVs) with clinical prognoses of patients with acute anterior circulation infarction by using susceptibility-weighted imaging (SWI). Methods Fifty patients with acute anterior circulation infarction, admitted to our hospital from August 2016 to December 2017, were enrolled in our study. SWI was performed to evaluate the DMVs. Univariate and multivariate Logistic regression models were used to determine the correlation between distribution of DMVs and clinical prognoses of patients. DMVs on the ipsilateral side of the lesions were further graded and analyzed; boxplot was used to describe its relation with modified Rankin scale (mRS) scores of the patients. Results DMVs were observed in 36 patients (72%), with 19 ipsilateral DMVs and 17 contralateral DMVs. The ipsilateral DMVs were independently associated with poor outcome (odds ratio=3.380, 95%CI: 1.006-11.393, P=0.049). The contralateral DMVs were not independent predictors for outcomes, but appeared commonly in patients with good outcome (44.8%). In patients with ipsilateral DMVs, grading 1, grading 2, and grading 3 were noted in 7, two and three patients, respectively; boxplot analysis showed that DMVs patients of grading 3 had higher mRS scores, with an average of 4. Conclusion The ipsilateral DMVs on SWI are independent predictive biomarkers for poor clinical outcome after stroke, and contralateral DMVs often indicate good prognosis. Key words: Susceptibility-weighted imaging; Deep medullary vein; Acute infarction; Anterior circulation; Clinical prognosis