Deep tiny flow voids along middle cerebral artery atherosclerotic occlusions: a high-resolution MR imaging study
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Published on: September 25, 2009
Wei-Hai Xu1, Ming-Li Li2, Jing-Wen Niu1
1Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Background And Purpose:
We aim to report the "deep tiny flow voids" (DTFV), a unique HR-MRI finding suggestive of deep collateral vessels along middle cerebral artery (MCA) occlusions.
Methods:
We retrospectively reviewed the HR-MRI data of 60 patients with unilateral MCA occlusion (32 symptomatic and 28 asymptomatic) and 205 control subjects with normal MCA on magnetic resonance angiography. The presence or absence of DTFV, defined as three or more flow voids along the occluded MCA on at least two consecutive T2-weighted image slices, was observed. The relationships among DTFV, clinical presentations, and infarct sizes were analyzed.
Results:
DTFV were identified in 20/28 (71%) patients with asymptomatic MCA occlusions, much more frequently than in the patients with symptomatic occlusions (5/32, 16%) (P<0.001). There were 9 patients with a large territorial infarction (≥ 1/3 MCA distribution), none of whom had DTFV on HR-MRI. DTFV was not observed in any control subject.
Conclusions:
DTFV are pathological conditions and associated with relatively good imaging outcomes and asymptomatic MCA occlusions. The function and clinical implications of DTFV warrant further investigations.
Insights
Deep tiny flow voids (DTFV) on HR-MRI are linked to asymptomatic middle cerebral artery (MCA) occlusions. This unique finding suggests collateral vessels and is associated with better imaging outcomes.
Area of Science:
- Neuroradiology
- Vascular Neurology
- Medical Imaging
Background:
- Middle cerebral artery (MCA) occlusions are a significant cause of stroke.
- Collateral circulation plays a crucial role in mitigating stroke severity.
- High-resolution magnetic resonance imaging (HR-MRI) offers detailed visualization of cerebral vasculature.
Purpose of the Study:
- To report and characterize "deep tiny flow voids" (DTFV), a novel HR-MRI finding.
- To investigate the association of DTFV with middle cerebral artery (MCA) occlusions.
- To explore the relationship between DTFV, clinical presentation, and infarct size.
Main Methods:
- Retrospective review of HR-MRI data from 60 patients with unilateral MCA occlusion.
- Inclusion of 205 control subjects with normal MCA on magnetic resonance angiography.
- Definition of DTFV as ≥3 flow voids along the MCA on ≥2 consecutive T2-weighted slices.
- Analysis of DTFV presence in relation to clinical symptoms and infarct volume.
Main Results:
- DTFV were identified in 71% of asymptomatic MCA occlusion patients versus 16% of symptomatic patients (P<0.001).
- None of the 9 patients with large territorial infarcts (≥1/3 MCA distribution) exhibited DTFV.
- DTFV were absent in all control subjects.
Conclusions:
- DTFV represent a pathological finding associated with asymptomatic MCA occlusions.
- The presence of DTFV correlates with favorable imaging outcomes.
- Further research is needed to elucidate the functional and clinical significance of DTFV.
