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Prolonged Venous Transit on MRI As A Prognostic Biomarker in Acute Ischemic Stroke: A Feasibility Study.

Prolonged Venous Transit on MRI As A Prognostic Biomarker in Acute Ischemic Stroke: A Feasibility Study. AJNR. American journal of neuroradiology Tsang, D. A., Gad, M., Cho, A., Lalwani, K., Salim, H. A., Lakhani, D. A., Koneru, M., Hui, F. K., Dmytriw, A. A., Liebeskind, D. S., Albers, G. W., Faizy, T. D., Yedavalli, V. S. 2026

Abstract

Prolonged venous transit (PVT) on CT perfusion is an established marker of poor collaterals and stroke severity; feasibility on MR perfusion (MRP) is uncertain. We evaluated feasibility and prognostic value of PVT on MRP in 59 patients with suspected acute ischemic stroke using a "straight-to-MRI" workflow. Board-certified neuroradiologists visually defined PVT as Tmax =10 s in the superior sagittal sinus and/or torcula. Pearson correlation tested associations between binary PVT and discharge NIHSS and 90-day modified Rankin Scale (mRS) in the full cohort and treated sub-cohort (IV thrombolysis and/or thrombectomy). PVT correlated with worse outcomes in the full cohort (NIHSS r=0.469, p=0.002; mRS r=0.387, p=0.02) and more strongly in treated patients (NIHSS r=0.678, p=0.005; mRS r=0.631, p=0.01). These findings demonstrate that PVT can be assessed on MRP and is a potentially promising post-revascularization prognostic biomarker aligning with CTP-based physiology; larger studies are needed.

View details for DOI 10.3174/ajnr.A9324

View details for PubMedID 41962954