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Updated: Jun 27, 2026
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Atherosclerosis of middle cerebral artery: evaluation with high-resolution MR imaging at 3T
Ming-li Li1, Wei-hai Xu, Lan Song
1Department of Radiology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Shuai Fu Yuan 1#, Dong Cheng District, Beijing 100730, China.
Objective:
Three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) has been wildly used in the diagnosis of intracranial artery diseases, but it only shows the arterial lumen and does not delineate the vessel wall. The aim of this study was to assess whether high resolution cross sectional magnetic resonance imaging (HRMRI) could compensate the limitation of 3D TOF MRA in the atherosclerotic disease of middle cerebral artery (MCA).
Methods:
Fourty-eight suspected patients with atherosclerotic stenosis of MCA underwent 3D TOF MRA and HRMRI with a 3T scanner. The HRMRI was performed in 49 MCAs perpendicular to the M1 segment with T2-weighted imaging. Findings of HRMRI were compared with that of 3D MRA.
Results:
HRMRI displayed the artery wall clearly, and showed 37 abnormalities, including 20 plaques and 17 wall thickening. The inter-observer reproducibility was moderate for wall abnormalities with k=0.75 (95% CI 0.59-0.91), and excellent for plaques with k=0.91 (95% CI 0.80-1.03). 3D TOF MRA showed 34 stenoses at the M1 segment. Five normal MCAs on 3D TOF MRA had abnormal wall (3 plaques and 2 wall-thickening) on HRMRI. Two stenoses on 3D TOF MRA showed normal wall structure on HRMRI, indicating a possible negative remodeling phenomenon.
Conclusions:
High-resolution MR imaging can clearly depict the wall structure of middle cerebral arteries. As a complementary method, HRMRI may compensate the limitation of 3D TOF MRA and help to detect atherosclerotic lesions not visualized by MRA.
Insights
High-resolution MR imaging (HRMRI) effectively visualizes middle cerebral artery walls, detecting atherosclerotic lesions missed by 3D TOF MRA. This complementary technique enhances diagnosis of intracranial artery disease.
Area of Science:
- Neuroradiology
- Vascular Imaging
- Medical Imaging
Background:
- Three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) is widely used for intracranial artery diseases.
- 3D TOF MRA primarily visualizes the arterial lumen, limiting its ability to assess vessel wall pathology.
- Atherosclerotic disease of the middle cerebral artery (MCA) requires detailed vessel wall assessment.
Purpose of the Study:
- To evaluate if high-resolution cross-sectional magnetic resonance imaging (HRMRI) can overcome the limitations of 3D TOF MRA.
- To assess the utility of HRMRI in diagnosing atherosclerotic disease of the MCA.
- To compare HRMRI findings with 3D TOF MRA in suspected MCA atherosclerotic stenosis.
Main Methods:
- Forty-eight patients with suspected MCA atherosclerotic stenosis underwent both 3D TOF MRA and HRMRI on a 3T scanner.
- HRMRI utilized T2-weighted imaging, acquired perpendicular to the M1 segment of 49 MCAs.
- Findings from HRMRI were directly compared against those from 3D TOF MRA.
Main Results:
- HRMRI clearly depicted MCA artery walls, identifying 37 abnormalities (20 plaques, 17 wall thickening).
- Inter-observer reproducibility was moderate for wall abnormalities (k=0.75) and excellent for plaques (k=0.91).
- HRMRI revealed abnormalities in 5 MCAs that appeared normal on 3D TOF MRA, and identified potential negative remodeling in 2 stenotic lesions.
Conclusions:
- High-resolution MR imaging provides clear visualization of middle cerebral artery wall structure.
- HRMRI serves as a valuable complementary tool to 3D TOF MRA.
- HRMRI can detect atherosclerotic lesions in MCAs that are not visible with conventional 3D TOF MRA, improving diagnostic accuracy.
