Middle cerebral artery plaque imaging using 3-Tesla high-resolution MRI
Kuniyasu Niizuma1, Hiroaki Shimizu, Shihomi Takada
1Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai 980-8574, Japan. niizuma@nsg.tohoku.ac.jp
Abstract:
Diagnosis of deep subcortical infarcts based on atherosclerosis of the middle cerebral artery (MCA) is important because this type of infarct is usually more aggressive than typical lacunar infarcts. However, current imaging techniques are of limited utility in the diagnosis of MCA plaques. Here, we report the use of 3-Tesla (3T) high-resolution moderate T2-weighted imaging (HRT2WI) to detect MCA plaques in three patients with acute MCA perforator territory infarcts. MCA plaques were seen with HRT2WI in a patient with MCA stenosis, which was observed by magnetic resonance angiography (MRA). Of the two patients without MCA stenosis (also confirmed by MRA), one had thin MCA plaques and the other had normal walls based on HRT2WI. Progression of symptoms occurred in the patients with plaques. We conclude that 3T HRT2WI can identify plaque on MCA walls and has the potential to identify patients at risk for stroke progression or recurrence.
Insights
High-resolution T2-weighted imaging (HRT2WI) can detect atherosclerosis plaques in the middle cerebral artery (MCA). This imaging technique shows potential for identifying patients at risk of stroke progression or recurrence.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Deep subcortical infarcts linked to middle cerebral artery (MCA) atherosclerosis are often more aggressive than lacunar infarcts.
- Current imaging methods have limitations in diagnosing MCA plaques, hindering effective treatment strategies.
Observation:
- This study utilized 3-Tesla (3T) high-resolution moderate T2-weighted imaging (HRT2WI) to visualize MCA plaques in three patients presenting with acute MCA perforator territory infarcts.
- HRT2WI successfully identified MCA plaques in a patient with confirmed MCA stenosis via magnetic resonance angiography (MRA).
- In patients without MCA stenosis (confirmed by MRA), HRT2WI revealed thin MCA plaques in one case and normal arterial walls in another.
Findings:
- 3T HRT2WI effectively detected MCA plaques, even in the absence of significant MCA stenosis.
- Patients with identified MCA plaques experienced symptom progression, suggesting a link between plaque presence and clinical outcomes.
Implications:
- 3T HRT2WI demonstrates potential as a valuable tool for identifying MCA atherosclerosis.
- This imaging modality may aid in identifying patients at higher risk for stroke progression or recurrence, enabling timely intervention.
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