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Intracranial atherosclerotic plaque enhancement in patients with ischemic stroke

M Skarpathiotakis1, D M Mandell, R H Swartz

  • 1Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, M5T Canada.

AJNR. American Journal of Neuroradiology
|August 4, 2012
PubMed
Abstract

Insights

Enhancing intracranial atherosclerotic plaque was strongly detected in all acute ischemic stroke patients within 4 weeks. Plaque enhancement decreased over time, suggesting a link between inflammation and stroke.

Area of Science:

  • Neuroimaging
  • Vascular Medicine
  • Radiology

Background:

  • Plaque inflammation is a key risk factor for ischemic stroke and myocardial infarction.
  • Magnetic resonance (MR) imaging can assess plaque inflammation via enhancement in carotid and coronary arteries.

Purpose of the Study:

  • To determine if enhancing intracranial atherosclerotic plaque is present in the artery supplying the infarction territory.
  • Utilize high-resolution vessel wall MR imaging for intracranial plaque assessment.

Main Methods:

  • Review of high-resolution 3T vessel wall MR imaging in 29 patients with ischemic stroke and intracranial stenosis.
  • Assessment of plaque enhancement presence and strength.

Main Results:

  • Sixteen patients imaged in the acute phase (<4 weeks), 5 in subacute (4-12 weeks), and 8 in chronic (>12 weeks).
  • All acute phase patients showed strong enhancement in plaque within the stroke territory vessel.
  • A trend of decreasing enhancement was observed with increased time post-stroke.

Conclusions:

  • Strong enhancement of intracranial atherosclerotic plaque was evident in all patients within 4 weeks of ischemic stroke.
  • Enhancement strength and presence diminished over time after the ischemic event.
  • Findings indicate a relationship between enhancing intracranial atherosclerotic plaque and acute ischemic stroke.

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