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

BackgroundIn 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 methodsThrombus-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.ResultsThirty 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, 18-50 ms vs. 45 9, 35-60 ms, P < 0.001).ConclusionA 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.