MR angiography and imaging for the evaluation of middle cerebral artery atherosclerotic disease

Area of Science:

• Neurology
• Radiology
• Vascular Medicine

Background:

• Intracranial atherosclerotic disease is a primary cause of ischemic stroke worldwide, especially in certain ethnic groups.
• Research has historically prioritized extracranial atherosclerosis over intracranial disease in developed nations.
• Intracranial stenosis is more prevalent than carotid stenosis in Asian, African, and Hispanic populations.

Purpose of the Study:

• To review the clinical presentations of middle cerebral artery (MCA) atherosclerosis and stenosis.
• To evaluate the utility of noninvasive magnetic resonance (MR) imaging in assessing intracranial vasculature.
• To explore future advancements in high-resolution MR imaging for intracranial atherosclerosis.

Main Methods:

• Review of existing literature on intracranial atherosclerosis and MR imaging techniques.
• Focus on noninvasive MR angiography (MRA) for intracranial vessel assessment.
• Discussion of high-resolution MR imaging capabilities for plaque visualization.

Main Results:

• MR angiography (MRA) is a validated, advantageous alternative to traditional angiography for intracranial vasculature.
• High-resolution MR imaging shows promise for detailed visualization of MCA stenosis and atherosclerotic plaque.
• Current imaging research has predominantly focused on extracranial atherosclerosis.

Conclusions:

• Noninvasive MR imaging, particularly high-resolution techniques, is crucial for evaluating intracranial atherosclerosis and stenosis.
• Advancements in MR imaging will improve the depiction of intracranial atherosclerotic disease.
• Improved imaging will guide endovascular therapy and facilitate the comparison of new interventions for stroke prevention.