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Updated: Mar 30, 2026
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Middle Cerebral Artery Atherosclerotic Plaques in Recent Small Subcortical Infarction: A Three-Dimensional
Xiao-Dong Zou1, Yiu-Cho Chung2, Lei Zhang2
1Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China.
Purpose:
Conventional two-dimensional vessel wall imaging has been used to depict the middle cerebral artery (MCA) wall in patients with recent small subcortical infarctions (RSSIs). However, its clinical use has been limited by restricted spatial coverage, low signal-to-noise ratio (SNR), and long scan time. We used a novel three-dimensional high-resolution MR imaging (3D HR-MRI) technique to investigate the presence, locations, and contrast-enhanced patterns of MCA plaques and their relationship with RSSI.
Methods:
Nineteen consecutive patients with RSSI but no luminal stenosis on MR angiography were prospectively enrolled. 3D HR-MRI was performed using a T1w-SPACE sequence at 3.0 T. The presence, locations, and contrast-enhanced patterns of the MCA plaques on the ipsilateral and contralateral sides to the RSSI were analyzed.
Results:
Eighteen patients successfully completed the study. MCA atherosclerotic plaques occurred more frequently on the ipsilateral than the contralateral side to the RSSI (72.2% versus 33.3%, P = 0.044). The occurrence of superiorly located plaques was significantly higher on the ipsilateral than the contralateral side of the MCA (66.7% versus 27.8%; P = 0.044).
Conclusions:
Superiorly located plaques are closely associated with RSSI. 3D high-resolution vessel wall imaging may be a potential tool for etiologic assessment of ischemic stroke.
Insights
Three-dimensional high-resolution MRI revealed that middle cerebral artery (MCA) plaques, particularly superiorly located ones, are more common on the side of recent small subcortical infarctions (RSSIs), suggesting a link to stroke etiology.
Area of Science:
- Neuroimaging
- Vascular Neurology
- Cardiovascular Imaging
Background:
- Conventional 2D vessel wall imaging for middle cerebral artery (MCA) assessment in recent small subcortical infarctions (RSSIs) is limited by spatial coverage, signal-to-noise ratio (SNR), and scan time.
- Investigating MCA plaques is crucial for understanding the etiology of ischemic stroke.
Purpose of the Study:
- To evaluate the utility of a novel three-dimensional high-resolution MRI (3D HR-MRI) technique.
- To investigate the presence, location, and contrast enhancement patterns of MCA plaques.
- To determine the relationship between MCA plaques and RSSI.
Main Methods:
- Nineteen patients with RSSI and no luminal stenosis on MR angiography were prospectively enrolled.
- 3D HR-MRI using a T1w-SPACE sequence at 3.0 T was performed.
- MCA plaque characteristics (presence, location, contrast enhancement) were analyzed on both ipsilateral and contralateral sides relative to the RSSI.
Main Results:
- Eighteen patients completed the study.
- MCA atherosclerotic plaques were more frequent ipsilateral to the RSSI (72.2%) compared to the contralateral side (33.3%).
- Superiorly located plaques were significantly more common on the ipsilateral side (66.7%) versus the contralateral side (27.8%).
Conclusions:
- Superiorly located MCA plaques are strongly associated with RSSI.
- 3D HR-MRI is a promising tool for the etiological assessment of ischemic stroke.
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