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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Intracranial arterial wall imaging using high-resolution 3-tesla contrast-enhanced MRI
R H Swartz1, S S Bhuta, R I Farb
1Division of Neuroradiology, Department of Medical Imaging, New East Wing, Toronto Western Hospital, University Health Network, 399 Bathurst St., Toronto, Ontario M5T2S8, Canada.
Neurology
|February 18, 2009
Summary
Three-tesla contrast-enhanced MRI shows promise for visualizing intracranial arterial walls. This advanced imaging can differentiate between atherosclerotic plaques, inflammation, and other pathologies, aiding in stroke diagnosis.
Area of Science:
- Neurology
- Radiology
- Vascular Imaging
Background:
- Conventional arterial imaging lacks specificity due to similar luminal defects from various pathologies.
- Intracranial wall imaging is limited by resolution and signal constraints, unlike extracranial imaging.
- Higher-field MRI scanners may enhance visualization of smaller intracranial vessels.
Purpose of the Study:
- To evaluate the utility of 3-tesla contrast-enhanced MRI for studying intracranial arterial walls.
- To assess the ability of specific MRI sequences to differentiate various intracranial arterial pathologies.
Main Methods:
- Consecutive patients with focal neurologic deficits underwent 3-tesla contrast-enhanced MRI.
- Multiplanar T2-weighted fast spin echo and T1 fluid-attenuated inversion recovery (FLAIR) pre- and postcontrast images were acquired.
- 37 patients with diverse clinical diagnoses were studied.
Main Results:
- 12/13 patients with atherosclerotic disease showed eccentric vessel wall enhancement.
- 2/3 patients with inflammatory diseases exhibited diffuse, concentric vessel wall enhancement.
- 3/3 patients with dissection displayed T1 bright signal, with 2 showing irregular enhancement, flap, and dual lumen.
Conclusions:
- 3-tesla contrast-enhanced MRI is feasible for intracranial arterial wall imaging.
- T2 and T1 FLAIR sequences may differentiate enhancement patterns of intracranial atherosclerosis, inflammation, and other wall pathologies.
- Prospective studies are needed to establish sensitivity and specificity for differentiating cerebral vascular conditions.
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