Imaging of intracranial plaques with black-blood double inversion recovery MR imaging and CT

We evaluated the feasibility of black-blood double inversion recovery magnetic resonance imaging (BBDIR) and CT imaging (CTI) for depiction of IAPs.

We performed BBDIR on 20 control subjects and 13 patients with acute ischemic stroke. We measured the thickness of the normal vessel wall in control subjects and the maximal and minimal thickness of IAPs in patients on BBDIR. We evaluated signal intensity (SI) and the eccentricity of the IAP on BBDIR, and abnormal wall thickening and CT attenuation of IAPs on CTI. We correlated imaging features of BBDIR and CTI in the patients.

The difference of wall thickness between control and patient group was statistically significant (control subjects; basilar artery 0.6 mm, MCA 0.51 mm, and patients; maximal 2.34 mm, minimal 1.3 mm, P value≤.001). The IAP showed eccentric remodeling and heterogeneous SI with the regions of high SI on BBDIR. CTI could not reveal abnormality in 10 patients. Suspicious intraplaque hemorrhage and calcification was demonstrated in 3 patients by CTI.

BBDIR could reveal normal and abnormal wall of large intracranial arteries. CTI had limited role for detection of IAP, however, correlation of BBDIR and CTI could provide further characterization of the IAP's in terms of intraplaque calcification and hemorrhage.