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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
High-resolution MRI identifies basilar artery plaques in paramedian pontine infarct
Isabelle F Klein1, Philippa C Lavallée, Elisabeth Schouman-Claeys
1Department of Radiology, Bichat University Hospital and Medical School, Denis Diderot University Paris VII, France.
Abstract:
Paramedian pontine infarct (PPI) is usually attributed to basilar artery (BA) atherosclerosis. However, this hypothesis has thus far been supported only by post-mortem studies. The authors show that high-resolution MRI is a promising method that can detect BA plaques in patients with PPI at or near the origin of the penetrating artery, whereas MR angiograms may appear normal.
Insights
Paramedian pontine infarct (PPI) is often linked to basilar artery (BA) atherosclerosis. High-resolution MRI can detect BA plaques near penetrating arteries in PPI patients, even when MR angiograms appear normal.
Area of Science:
- Neurology
- Vascular Imaging
- Cerebrovascular Diseases
Background:
- Paramedian pontine infarct (PPI) is typically attributed to basilar artery (BA) atherosclerosis.
- Previous evidence linking PPI to BA atherosclerosis primarily comes from post-mortem studies.
- The precise etiology of PPI, particularly the role of BA atherosclerosis, requires further investigation using advanced imaging techniques.
Purpose of the Study:
- To investigate the utility of high-resolution MRI in detecting basilar artery (BA) atherosclerosis in patients with paramedian pontine infarct (PPI).
- To compare the findings of high-resolution MRI with conventional MR angiography in identifying BA plaques associated with PPI.
- To assess the potential of high-resolution MRI as a diagnostic tool for BA atherosclerosis in the context of PPI.
Main Methods:
- Utilized high-resolution magnetic resonance imaging (MRI) to visualize the basilar artery (BA) in patients diagnosed with paramedian pontine infarct (PPI).
- Examined BA plaques, particularly at or near the origin of penetrating arteries supplying the pons.
- Compared findings from high-resolution MRI with results from standard MR angiography (MRA) in the same patient cohort.
Main Results:
- High-resolution MRI successfully detected basilar artery (BA) plaques in patients with paramedian pontine infarct (PPI).
- These plaques were often located at or near the origin of penetrating arteries.
- In some cases, conventional MR angiograms (MRA) appeared normal despite the presence of detectable BA plaques on high-resolution MRI.
Conclusions:
- High-resolution MRI is a promising imaging modality for identifying basilar artery (BA) atherosclerosis in patients with paramedian pontine infarct (PPI).
- This technique can reveal BA plaques missed by standard MR angiography, especially those at the origin of penetrating arteries.
- High-resolution MRI may improve the diagnostic accuracy for the underlying cause of PPI.
