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Updated: Aug 16, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Multiparametric MRI and ultrasound findings in patients with internal carotid artery dissection

Oliver Lanczik1, Kristina Szabo, Michael Hennerici

  • 1Department of Neurology, Universitätsklinikum Mannheim, University of Heidelberg, Mannheim, Germany.

Neurology
|August 10, 2005
PubMed

Insights

Internal carotid artery dissections (ICADs) with concentric mural hematomas often cause acute ischemic brain lesions. Eccentric hematomas are less likely to cause stroke, sometimes with normal ultrasound findings.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Internal carotid artery dissection (ICAD) is a significant cause of stroke in young adults.
  • Understanding the imaging characteristics of ICAD is crucial for predicting ischemic events.

Purpose of the Study:

  • To investigate the correlation between mural hematoma position on MRI and the presence of acute ischemic brain lesions in patients with ICAD.
  • To evaluate the utility of ultrasound in identifying ICAD features associated with ischemia.

Main Methods:

  • Retrospective analysis of clinical, MRI, and ultrasound data from 33 patients with 37 confirmed ICADs.
  • Diffusion-weighted MRI (DWI) was used to detect acute ischemic lesions.
  • Mural hematoma location (concentric vs. eccentric) was assessed on MRI.

Main Results:

  • 64.9% of ICADs were associated with acute ischemic lesions on DWI.
  • Concentric mural hematomas were more frequent in ICADs with DWI lesions (58.3%).
  • Eccentric mural hematomas were observed in ICADs without DWI lesions (76.9%), sometimes with normal ultrasound (38.5%).

Conclusions:

  • Mural hematoma position on MRI is a significant imaging marker for predicting acute ischemic brain lesions in ICAD.
  • Eccentric hematomas may indicate a lower risk of acute ischemia, even with non-specific clinical signs or normal ultrasound.
  • Further research into hemodynamic patterns in ICAD is warranted.

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