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High-resolution magnetic resonance imaging of symptomatic middle cerebral artery dissection
Hyo Sung Kwak1, Seung Bae Hwang1, Gyung Ho Chung1
1Department of Radiology, Chonbuk National University Hospital and Medical School, Keumam-Dong, Jeonju, Jeonbuk; Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Keumam-Dong, Jeonju, Jeonbuk.
Abstract:
Dissection of the middle cerebral artery (MCA) is less frequent compared with dissection of vessels in the vertebrobasilar system or dissection of the carotid artery. High-resolution cross-sectional magnetic resonance imaging (HRMRI) has emerged as a potential technique for atherosclerotic plaque imaging in MCA. We enrolled 3 patients with MCA dissection on whom HRMRI was performed for evaluation of MCA stenosis. Two patients had an embolic infarction in the MCA territory and focal dissection. One patient had a massive infarction in the MCA territory and long-segment dissection of the MCA. On HRMRI, our objectives had an intimal flap with patency of the lumen and 1 had extensive hemorrhaging in the false lumen.
Insights
Middle cerebral artery (MCA) dissection is rare. High-resolution MRI effectively visualized intimal flaps and hemorrhaging in MCA dissections, aiding stenosis evaluation in patients with stroke.
Area of Science:
- Neurology
- Vascular Imaging
- Neurointerventional Radiology
Background:
- Middle cerebral artery (MCA) dissection is an uncommon cerebrovascular event.
- High-resolution cross-sectional magnetic resonance imaging (HRMRI) shows promise for evaluating atherosclerotic plaque in the MCA.
- This study explores HRMRI's utility in diagnosing MCA dissection.
Observation:
- Three patients with MCA dissection underwent HRMRI for stenosis assessment.
- Two patients presented with embolic infarction and focal dissection.
- One patient experienced massive infarction with long-segment MCA dissection.
Findings:
- HRMRI identified intimal flaps and lumen patency in MCA dissections.
- Evidence of extensive hemorrhage within the false lumen was observed in one case.
- The technique facilitated the evaluation of MCA stenosis severity.
Implications:
- HRMRI is a valuable tool for diagnosing and characterizing MCA dissection.
- Accurate imaging aids in understanding stroke etiology and guiding treatment strategies.
- Further research can refine HRMRI protocols for cerebrovascular dissections.
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