Abstract: Objective To investigate the application of magnetic resonance imaging (MRI) fluid-attenuated inversion recovery vascular hyperintensities (FVH) for the diagnosis of transient ischemic attack (TIA). Methods Consecutive 218 inpatients for TIA from May 2011 to July 2013 were reviewed with gender, age, cardiovascular risk factors, TIA or a history of stroke, TIA duration, and calculate the ABCD2 scores. All patients accepted MRI and MRA within 24 hours of symptom onset. FVH positive patients would follow up MRI and MRA within 7 days. All the patients were followed up in 90 days. Results FVH was identified in 45 patients (21%), 15 cases of them was found diffusion weighted imaging (DWI) hyperintensities on the same sides. The prevalence of atrial fibrillation (AF, P<0.001), DWI positive (P= 0.010) and arterial occlusive lesions (AOL, P=0.003) were more in the FVH positive patients than in the negative ones, while the duration of symptoms was shorter (P=0.010). Multivariate Logistic regression analysis showed that AF (OR=7.17, 95% CI: 2.71-18.4), AOL (OR=4.93, 95% CI: 3.53-12.6) and hemiplegic (OR=2.84, 95% CI: 1.21-7.42) independently associated with FVH. 7 days after the onset, FVH was not found in 15 patients (65%, transient FVH), in whom the prevalence of AF was more (P=0.020), and AOL was less (P<0.001). A total of 197 patients (90%) were successfully followed up. In the FVH-positive patients, 5 cases developed into recurrent TIA and 6 into ischemic stroke (IS), focused on the the same sides of FVH; while the FVH-negative patients, 2 cases developed into recurrent TIA and 5 into IS. COX proportional hazard analysis showed that FVH (HR=3.64, 95% CI: 1.08-12.6) and AOL (HR=3.82, 95% CI: 1.07-15.8) independently associated with the recurrence of TIA or IS. Conclusion FVH can be helpful for the diagnosis of TIA and predictions for recurrent TIA or IS after a TIA.

Key words: stroke, transient ischemic attack, magnetic resonance imaging, fluid-attenuated inversion recovery, diffusion weighted imaging