The brush-sign has aroused significant interest in recent years. The brush-sign refers to the abnormal visibility of enlarged deep medullary veins on GRE T2 *WI related to an increase of blood deoxyhemoglobin concentration ( 3– 6). Following multivariable analysis, the brush-sign no longer affected DWI-ASPECTS < 7 while the latter remained associated with younger age, male sex (OR 1.79, 95% CI 1.08–2.99), a higher National Institutes of Health Stroke Scale (NIHSS) score (OR 1.16, 95% CI 1.1–1.21), a poor collateral status (OR 9.35, 95% CI 5.59-16.02), MCA segment (OR 2.54, 95% CI 1.25–5.38), and intracranial ICA (OR 3.01, 95% CI 1.16–8) occlusion.Ĭonclusions and Relevance: The brush-sign may be a marker of poor collateral status but did not independently predict a lower DWI-ASPECTS.Ĭlinical Trial Registration:, identifier: NCT04620642.Īssessment of vessels using gradient recalled echo T2 *-weighted imaging (GRE T2 *WI) may provide insights into acute ischemic stroke (AIS) pathophysiology ( 1– 4). In univariable analysis, a DWI-ASPECTS < 7 was associated with a brush sign. Patients with a brush-sign more frequently had a poor collateral status. Results: In this study, 504 patients were included, among which 171 (33.9%) patients had a brush-sign. Collateral status was assessed on digital subtraction angiography according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) score. The brush-sign was assessed on T2-gradient-echo MRI. Methods: Consecutive patients admitted in the Lyon Stroke Center with anterior circulation AIS due to intracranial internal carotid artery (ICA) and/or M1 or M2 segment of the middle cerebral artery (MCA) occlusion eligible for MT were included. We aimed to assess the relationship between the brush-sign and collateral status and its potential impact on baseline diffusion-weighted imaging–Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) in acute ischemic stroke (AIS) patients eligible to mechanical thrombectomy (MT). Introduction: The relevance of the brush-sign remained poorly documented in large vessel occlusion (LVO). 4CarMeN Laboratory, INSERM, University Lyon 1, Lyon, France.3Clinical Investigation Center, Hospices Civils de Lyon, INSERM, Lyon, France.2Department of Neuroradiology, Hospices Civils de Lyon, Lyon, France.1Department of Stroke, Hospices Civils de Lyon, Lyon, France.Lucie Rascle 1, Alexandre Bani Sadr 2, Camille Amaz 3, Nathan Mewton 3, Marielle Buisson 3, Marc Hermier 2, Elodie Ong 1,4, Julia Fontaine 1, Laurent Derex 1, Yves Berthezène 2, Omer Faruk Eker 2, Tae-Hee Cho 1,4, Norbert Nighoghossian 1,4 † and Laura Mechtouff 1,4 * †
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