{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:23:29Z","timestamp":1747196609463,"version":"3.40.5"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>We aimed to validate hyperintense vessel sign (HVS) on FLAIR imaging or posterior cerebral artery (PCA) laterality on MR angiography beyond 4.5 hours after stroke onset.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Data from acute ischemic stroke patients with internal carotid or middle cerebral artery occlusion who underwent CT perfusion imaging at baseline, follow-up MR perfusion imaging and angiography within 30 hours after stroke, without effective recanalization on follow-up imaging, were analysed retrospectively. Patients were separately classified as high or low HVS (&gt;5 or \u22645 slices of HVS), and PCA laterality positive or negative group. We compared core and penumbra volumes at follow-up imaging and neurological outcomes between high or low HVS group, and between PCA laterality positive or negative group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 49 patients analyzed, four patients with artifacts were excluded and 45 were classified into high (n = 23) or low (n = 22) HVS group. High group had a smaller core volume (median 32 ml versus 109 ml, p = 0.004), larger penumbra volume at follow-up (68 ml versus 0 ml, p = 0.001), and better outcomes (modified Rankin Scale at three months, 3 versus 5, p = 0.03). For PCA laterality analysis, 1 patient with previously occluded PCA was excluded and 48 patients were classified as positive (n = 22) or negative (n = 26). Positive group had larger core volume (116 ml versus 37 ml), and no significant differences in penumbral volumes or outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Prominent HVS in later time was associated with small core volume, persistent penumbra volume and favorable outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0309779","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T17:29:53Z","timestamp":1725384593000},"page":"e0309779","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Collateral assessment on magnetic resonance imaging\/angiography up to 30 hours after stroke onset"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9680-1723","authenticated-orcid":true,"given":"Shinya","family":"Tomari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Lillicrap","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Garcia-Esperon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumi","family":"Tomari Kashida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Bivard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Longting","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher R.","family":"Levi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9023-6177","authenticated-orcid":true,"given":"Neil J.","family":"Spratt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"pone.0309779.ref001","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1056\/NEJMoa1713973","article-title":"Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging","volume":"378","author":"GW Albers","year":"2018","journal-title":"New England Journal of Medicine"},{"key":"pone.0309779.ref002","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1706442","article-title":"Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct","volume":"378","author":"RG Nogueira","year":"2018","journal-title":"New England Journal of Medicine"},{"key":"pone.0309779.ref003","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1093\/brain\/awp155","article-title":"The independent predictive utility of computed tomography angiographic collateral status in acute ischaemic stroke","volume":"132","author":"F Miteff","year":"2009","journal-title":"Brain"},{"key":"pone.0309779.ref004","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1148\/radiol.15142256","article-title":"Multiphase CT Angiography: A New Tool for the Imaging Triage of Patients with Acute Ischemic Stroke","volume":"275","author":"BK Menon","year":"2015","journal-title":"Radiology"},{"key":"pone.0309779.ref005","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1161\/STROKEAHA.113.003857","article-title":"Hypoperfusion Intensity Ratio Predicts Infarct Progression and Functional Outcome in the DEFUSE 2 Cohort","volume":"45","author":"JM 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Neurol"},{"key":"pone.0309779.ref012","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1161\/STROKEAHA.112.674101","article-title":"Posterior cerebral artery laterality on magnetic resonance angiography predicts long-term functional outcome in middle cerebral artery occlusion","volume":"44","author":"M Ichijo","year":"2013","journal-title":"Stroke"},{"key":"pone.0309779.ref013","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1148\/radiol.2015150319","article-title":"Whole-brain CT perfusion to quantify acute ischemic penumbra and core","volume":"279","author":"L Lin","year":"2016","journal-title":"Radiology"},{"key":"pone.0309779.ref014","first-page":"e161","article-title":"Association of Collateral Status and Ischemic Core Growth in Patients With Acute Ischemic Stroke","volume":"96","author":"L Lin","year":"2021","journal-title":"Neurology"},{"key":"pone.0309779.ref015","first-page":"1","article-title":"Ischemic Lesion Growth in Patients with a Persistent Target Mismatch After Large Vessel Occlusion","author":"S Tomari","year":"2022","journal-title":"Clin Neuroradiol"},{"key":"pone.0309779.ref016","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1161\/01.STR.0000086465.41263.06","article-title":"Collateral circulation","volume":"34","author":"DS Liebeskind","year":"2003","journal-title":"Stroke"},{"key":"pone.0309779.ref017","doi-asserted-by":"crossref","first-page":"3360","DOI":"10.1161\/STROKEAHA.119.026299","article-title":"Collateral Circulation and Outcome in Atherosclerotic Versus Cardioembolic Cerebral Large Vessel Occlusion","volume":"50","author":"V Guglielmi","year":"2019","journal-title":"Stroke"},{"key":"pone.0309779.ref018","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/ene.13287","article-title":"Stroke etiology and collaterals: atheroembolic strokes have greater collateral recruitment than cardioembolic strokes","volume":"24","author":"LC Rebello","year":"2017","journal-title":"Eur J Neurol"},{"key":"pone.0309779.ref019","article-title":"Effect of intravenous thrombolysis on core growth rate in patients with acute cerebral infarction","volume":"14","author":"X Wang","year":"2023","journal-title":"Front Neurol"},{"key":"pone.0309779.ref020","doi-asserted-by":"crossref","first-page":"3241","DOI":"10.1161\/STROKEAHA.115.010721","article-title":"Alteplase Reduces Downstream Microvascular Thrombosis and Improves the Benefit of Large Artery Recanalization in Stroke","volume":"46","author":"JP Desilles","year":"2015","journal-title":"Stroke"}],"container-title":["PLOS 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