• Min-Gyu Park, Chang Hyo Yoon, Seung Kug Baik, and Kyung-Pil Park.
• Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
• J Stroke Cerebrovasc Dis. 2015 Jun 1; 24 (6): 1229-34.

BackgroundSusceptibility vessel sign (SVS) on susceptibility-weighted imaging (SWI) has a high sensitivity and specificity to detect the intra-arterial thrombus in anterior circulation stroke. However, SVS has not been evaluated in posterior circulation stroke.MethodsWe reviewed the data from patients with acute posterior cerebral artery (PCA) infarction within 24 hours from stroke onset. To elucidate the usefulness of SVS for the detection of intraluminal thrombus in acute PCA infarction, the frequency and location of SVS were compared with those of occlusion on magnetic resonance angiography (MRA) and hyperdense PCA sign on computed tomography (CT).ResultsTwenty-five patients with acute PCA infarction were enrolled in the study. The SVS was found in 92% (23 of 25). MRA showed occlusions in 64% (16 of 25). The SVS was identified in 100% (16 of 16) of patients with occlusion on MRA. Patients without occlusion on MRA also showed the SVS in 78% (7 of 9; P = .0233). The positive SVS without occlusion on MRA was mainly identified in patients with occlusion of distal branches of PCA; P3 segment in 4 and P4 segment in 3. However, the hyperdense PCA sign on CT showed in only 8% (2 of 25) of all patients; its sensitivity was significantly lower than those of the SVS on SWI (P < .001).ConclusionsSWI is more sensitive than MRA for the detection of intraluminal thrombus, especially peripheral one, in patients with acute ischemic stroke of the PCA territory. In addition, irrespective of thrombus location, SWI is significantly superior to CT in detecting thrombus in acute PCA infarction.Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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