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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
High resolution MR imaging in patients with symptomatic middle cerebral artery stenosis
Gyung Ho Chung1, Hyo Sung Kwak, Seung Bae Hwang
1Department of Radiology and Research Institute of Medical Science, Chonbuk National University Medical School, 634-18, Keumam-Dong, Jeonju-shi, Chonbuk 561-712, South Korea.
Purpose:
High resolution magnetic resonance imaging (HRMRI) has been used as an imaging modality to depict the intracranial artery wall. The aim of this study was to compare images of the vessel wall between symptomatic and asymptomatic atherosclerotic plaques of the middle cerebral artery (MCA) using HRMRI.
Materials And Methods:
From September 2009 to August 2010 we prospectively screened consecutive patients for MCA stenosis using time-of-flight (TOF) MR angiography. We studied 14 patients with symptomatic MCA stenosis and 16 patients with asymptomatic MCA stenosis. The HRMRI protocol included three different scans: T1-, T2-, and proton density (PD)-weighted black blood MRI. The cross-sectional images of the MCA wall on HRMRI were compared between the two groups based on the degree of stenosis, remodeling ratio, outward or inward remodeling, plaque signal intensity, plaque surface irregularity, and presence of an intact inner wall.
Results:
The degree of MCA stenosis and the ratio of plaque thickening to patent lumen in the symptomatic group were significantly higher than in the asymptomatic group. Outward remodeling of the stenotic area in symptomatic group was significantly higher than that seen in the asymptomatic group, and the reverse was true for inward remodeling of the stenotic area (it was significantly higher in the asymptomatic group compared to the symptomatic group). T2- and PD-weighted high signal foci, eccentric wall thickening, and plaque volume in the stenotic area were all similar between the two groups.
Conclusions:
HRMRI has the potential to distinguish between atherosclerotic plaques in symptomatic and asymptomatic MCA stenoses.
Insights
High-resolution magnetic resonance imaging (HRMRI) can differentiate between symptomatic and asymptomatic atherosclerotic plaques in the middle cerebral artery (MCA). This imaging technique shows differences in plaque characteristics, aiding in distinguishing plaque types.
Area of Science:
- Neuroimaging
- Vascular Medicine
- Radiology
Background:
- High-resolution magnetic resonance imaging (HRMRI) is a key tool for visualizing intracranial artery walls.
- Atherosclerotic plaques in the middle cerebral artery (MCA) can be symptomatic or asymptomatic, necessitating methods to differentiate them.
Purpose of the Study:
- To compare vessel wall images of symptomatic versus asymptomatic atherosclerotic plaques in the MCA using HRMRI.
- To identify HRMRI-detectable differences between symptomatic and asymptomatic MCA atherosclerotic plaques.
Main Methods:
- Prospective screening of patients with MCA stenosis using time-of-flight MR angiography.
- HRMRI (T1-, T2-, PD-weighted black blood MRI) was performed on 14 symptomatic and 16 asymptomatic MCA stenosis patients.
- Comparison of MCA wall cross-sections based on stenosis degree, remodeling, plaque signal, surface irregularity, and inner wall integrity.
Main Results:
- Symptomatic MCA stenosis showed significantly higher stenosis degree and plaque thickening ratio compared to asymptomatic.
- Outward remodeling was significantly higher in symptomatic plaques, while inward remodeling was higher in asymptomatic plaques.
- No significant differences were observed in T2/PD high signal foci, eccentric wall thickening, or plaque volume between symptomatic and asymptomatic groups.
Conclusions:
- HRMRI demonstrates potential in distinguishing between atherosclerotic plaques in symptomatic and asymptomatic MCA stenoses.
- Specific imaging features identified by HRMRI may help differentiate plaque types, aiding clinical assessment.
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