Susceptibility weighted imaging for detection of thrombus in acute ischemic stroke: A cross-sectional study

Background and AimsSusceptibility-weighted imaging (SWI) can help in the diagnosis of thrombus within the vessel in acute ischemic stroke, known as susceptibility vessel sign (SVS), and detection of SVS within the vessel can predict treatment modality and outcome. In this study, the purpose is to correlate the SVS on SWI with different parameters of stroke.MethodsThis prospective cross-sectional study enrolled consecutive stroke patients with vessel occlusion on magnetic resonance angiography (MRA) over 1 year. The relationship between SVS on SWI with risk factors, territory involved, and length of thrombus was correlated with the National Institutes of Health Stroke Scale (NIHSS).ResultsA total of 105 patients were enrolled in this study. Sixty-two percent (66 out of 105) of patients showed SVS on SWI with MRA-positive occlusion. A positive correlation was observed between SVS on SWI and the risk factor (p = 0.003, chi-square test), with 86% of patients with heart disease and 47% with hypertension exhibiting SVS. Additionally, a positive correlation was observed between SVS on SWI and territorial occlusion (p = 0.000, chi-square test). A moderate positive correlation was observed between the NIHSS and thrombus length (p = 0.002, Pearson's correlation coefficient), with a Pearson's coefficient of 0.367.ConclusionsSWI can be useful in identifying the location of the thrombus, and NIHSS can determine the thrombus length in acute stroke. A higher incidence of SVS can be associated with risk factors, and it also depends upon the site of occlusion of the vessel. Sixty-two percent of patients showed susceptibility vessel sign (SVS) on susceptibility-weighted imaging (SWI) with magnetic resonance angiography (MRA)-positive occlusion, indicating the potential of SWI in assessing stroke severity. Positive correlations were observed between SVS and risk factors (heart disease, hypertension), territorial occlusion, and a moderate correlation between the NIH Stroke Scale (NIHSS) score and thrombus length. SWI is highlighted as a valuable tool due to its superior sensitivity in detecting blood products and vascular anomalies, emphasizing its role in identifying thrombus location and predicting treatment outcomes in acute ischemic stroke.