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@ARTICLE{Mundiyanapurath:130211,
      author       = {S. Mundiyanapurath and P. A. Ringleb and S. Diatschuk and
                      S. Burth and M. Möhlenbruch and R. O. Floca and W. Wick$^*$
                      and M. Bendszus and A. Radbruch$^*$},
      title        = {{C}ortical vessel sign on susceptibility weighted imaging
                      reveals clinically relevant hypoperfusion in internal
                      carotid artery stenosis.},
      journal      = {European journal of radiology},
      volume       = {85},
      number       = {3},
      issn         = {0720-048X},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2017-05291},
      pages        = {534 - 539},
      year         = {2016},
      abstract     = {Internal carotid artery (ICA) stenosis can lead to cerebral
                      hypoperfusion and is a common cause of stroke. As
                      susceptibility weighted imaging (SWI) has been used for
                      penumbra imaging in acute ischemic stroke, we aimed at
                      analyzing hypoperfusion using SWI in patients with ICA
                      stenosis.Clinical characteristics, asymmetric cortical
                      vessel sign (more and/or larger, hypointense asymmetric
                      cortical vessels) on SWI, Doppler sonography results and
                      diffusion weighted imaging (DWI) lesion volume were
                      retrospectively analyzed in patients with ICA stenosis. In a
                      subgroup of patients, volume of prolonged time to peak and
                      volume of prolonged time to peak of the residue curve (Tmax)
                      were measured as reference standard. Outcome was assessed as
                      modified Rankin score at discharge.104 patients were
                      included. Median age was 72 and median degree of stenosis
                      $70\%$ according to NASCET. $13\%$ had a asymmetric cortical
                      vessel sign. These patients had a higher degree of stenosis
                      $(80\%$ vs. $70\%,$ p=0.004), were more often symptomatic
                      $(93\%$ vs. $61\%,$ p=0.020) and had higher DWI volume
                      (7.3ml vs. 0.2ml, p=0.011). Specificity for the prediction
                      of DWI lesions was $86\%.$ Also, patients with asymmetric
                      cortical vessel sign had lower rates of favorable outcome
                      (mRS=0-2; $57\%$ vs. $82\%,$ p=0.033) and volumes of
                      Tmax≥4s, ≥6s, ≥8s, ≥10s and TTP≥2s, ≥4s, ≥6s
                      were significantly higher. In multivariate analysis,
                      asymmetric cortical vessel sign was an independent negative
                      predictor of favorable outcome (mRS 0-2; OR 0.184; CI
                      [0.039; 0.875] p=0.033).In patients with ICA stenosis,
                      asymmetric cortical vessel sign is a sign of clinically
                      relevant hypoperfusion.},
      cin          = {E071 / G370 / E012 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)E071-20160331 / I:(DE-He78)G370-20160331 /
                      I:(DE-He78)E012-20160331 / I:(DE-He78)L101-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:26860664},
      doi          = {10.1016/j.ejrad.2015.12.020},
      url          = {https://inrepo02.dkfz.de/record/130211},
}