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Updated: Mar 28, 2026
Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
Diffusion measurement of intraplaque hemorrhage and intramural hematoma using diffusion weighted MRI at 3T in
Bin Yao1, Li Yang2, Guangbin Wang3
1The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
Insights
Diffusion-weighted imaging (DWI) can differentiate between hemorrhagic and non-hemorrhagic carotid plaques using apparent diffusion coefficient (ADC) values. DWI also helps distinguish carotid intraplaque hemorrhage (IPH) from intramural hematoma (IMH) in artery dissection.
Area of Science:
- Radiology and Imaging Science
- Cardiovascular Imaging
- Neuroimaging
Background:
- Carotid plaques can be hemorrhagic or non-hemorrhagic, with hemorrhage indicating increased risk.
- Distinguishing intraplaque hemorrhage (IPH) from intramural hematoma (IMH) in cervical artery dissection is clinically important.
- Diffusion-weighted imaging (DWI) offers insights into tissue microstructure.
Purpose of the Study:
- To evaluate the utility of diffusion-weighted imaging (DWI) in differentiating hemorrhagic from non-hemorrhagic carotid plaques.
- To assess the ability of apparent diffusion coefficient (ADC) measurements to characterize carotid intraplaque hemorrhage (IPH).
- To differentiate intramural hematoma (IMH) associated with cervical artery dissection from IPH using DWI.
Main Methods:
- Fifty-one symptomatic patients underwent 3.0-T carotid MRI, including conventional sequences, 3D MPRAGE, and DWI.
- Patients were categorized into hemorrhagic plaque, non-hemorrhagic plaque, and IMH groups based on 3D MPRAGE.
- Apparent diffusion coefficient (ADC) values were measured for each group and analyzed using t-tests.
Main Results:
- Mean ADC values were significantly lower in hemorrhagic plaques (1.284 × 10⁻³ mm²/s) compared to non-hemorrhagic plaques (1.766 × 10⁻³ mm²/s).
- Hemorrhagic regions within plaques exhibited lower ADC values (0.985 × 10⁻³ mm²/s) than non-hemorrhagic regions (1.480 × 10⁻³ mm²/s).
- Intramural hematoma (IMH) showed the lowest mean ADC values (0.563 × 10⁻³ mm²/s), significantly differing from hemorrhagic plaques (P < 0.05).
Conclusions:
- Diffusion-weighted imaging (DWI) is a valuable tool for identifying hemorrhage in carotid plaques.
- Apparent diffusion coefficient (ADC) measurements can effectively distinguish hemorrhagic from non-hemorrhagic carotid plaques.
- DWI aids in differentiating intramural hematoma (IMH) from intraplaque hemorrhage (IPH) in cervical artery dissection.
Objectives:
To assess the difference between carotid haemorrhagic plaque and non-haemorrhagic plaque by using diffusion-weighted imaging (DWI) and to evaluate carotid intraplaque haemorrhage (IPH) and intramural hematoma (IMH) of cervical artery dissection with apparent diffusion coefficient (ADC) measurement.
Methods:
Fifty-one symptomatic patients underwent 3.0-T carotid MR imaging, including conventional sequences, three-dimensional (3D) magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence, and DWI. Thirty-nine patients with carotid plaque and eight patients with IMH of cervical artery dissection were finally included. The groups of hemorrhagic plaque, non-hemorrhagic plaque and IMH were divided according to 3D MPRAGE sequence. ADC values of different groups were measured, and t tests were performed.
Results:
The mean ADC values of hemorrhagic plaques, non-hemorrhagic plaque and IMH were (1.284 ± 0.327) × 10(-3)mm(2)/s, (1.766 ± 0.477) × 10(-3)mm(2)/s, and (0.563 ± 0.119) × 10(-3)mm(2)/s, respectively. The mean ADC values of hemorrhagic and non-hemorrhagic regions in the hemorrhagic plaque group were (0.985 ± 0.376) × 10(-3)mm(2)/s and (1.480 ± 0.465) × 10(-3)mm(2)/s, respectively. The differences between the hemorrhagic plaque and non-hemorrhagic plaque, hemorrhagic region and non-hemorrhagic region in hemorrhagic plaque, and the hemorrhagic region in the hemorrhagic plaque and IMH of artery dissection were significant (P < 0.05).
Conclusion:
DWI may be a useful complement to conventional MR imaging for identifying haemorrhage of carotid plaques and differentiate IMHs from IPH.
Key Points:
• ADC values of IPH are lower than the plaque without IPH. • DWI might be a useful complement to identify IPH. • IMH may be differentiated from IPH by using DWI.
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