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Middle cerebral artery intraplaque hemorrhage: prevalence and clinical relevance

Wei-Hai Xu1, Ming-Li Li, Shan Gao

  • 1Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. xuwhpumch@yahoo.com.cn

Annals of Neurology
|February 28, 2012
PubMed
Abstract

Insights

High T1-weighted fat-suppressed imaging (HST1) in middle cerebral artery (MCA) plaques indicates intraplaque hemorrhage. This finding on high-resolution MRI is linked to stroke, offering insights into MCA atherosclerosis.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Biology

Background:

  • The composition of middle cerebral artery (MCA) plaques and their clinical correlation remain poorly understood.
  • Intraplaque hemorrhage is a marker of plaque instability and a predictor of stroke.
  • High-resolution magnetic resonance imaging (HR-MRI) offers detailed plaque characterization.

Purpose of the Study:

  • To investigate the occurrence of high signal on T1-weighted fat-suppressed images (HST1) in MCA plaques using HR-MRI.
  • To determine the association between HST1 and clinical presentation in patients with high-grade MCA stenosis.

Main Methods:

  • Retrospective analysis of HR-MRI and clinical data from 107 adult patients with >70% MCA stenosis.
  • Definition of HST1 as signal intensity >150% of adjacent muscles on HR-MRI.
  • Statistical analysis to compare HST1 rates between symptomatic and asymptomatic MCA plaques.

Main Results:

  • A total of 109 MCA plaques were analyzed from 981 image slices.
  • HST1 was detected in 10.1% of plaques (11/109), predominantly in symptomatic cases (19.6% vs 3.2%).
  • The difference in HST1 occurrence between symptomatic and asymptomatic MCAs was statistically significant (p=0.01).

Conclusions:

  • HST1 within MCA plaques, visualized by HR-MRI, is significantly associated with ipsilateral stroke.
  • This finding provides novel insights into the vascular biology and instability of MCA atherosclerosis.
  • HR-MRI detection of HST1 may aid in identifying high-risk MCA plaques.

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