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Updated: Feb 23, 2026
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging
Wen-Jie Yang1, Ka-Sing Wong1, Xiang-Yan Chen1
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong.
Insights
Intracranial atherosclerosis, a major cause of ischemic stroke, disproportionately affects certain ethnicities. High-resolution magnetic resonance imaging (HRMRI) shows promise for visualizing vessel wall pathology, but requires histopathological validation.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Intracranial atherosclerosis is a primary cause of ischemic stroke, particularly in Asian, African, and Hispanic populations.
- While sharing similarities with extracranial atherosclerosis, intracranial disease exhibits distinct onset and severity patterns.
- High-resolution magnetic resonance imaging (HRMRI) offers direct visualization of intracranial vessel wall pathology.
Purpose of the Study:
- To review the histological features of intracranial atherosclerosis.
- To present current evidence validating MR vessel wall imaging against histopathology for intracranial lesions.
Main Methods:
- Literature review focusing on histopathological studies of intracranial atherosclerosis.
- Analysis of studies correlating HRMRI findings with histopathological validation of plaque components and vulnerability.
Main Results:
- Histopathological examination reveals specific features of intracranial atherosclerotic plaques.
- Evidence supports the validation of HRMRI signal characteristics for depicting plaque components and vulnerability in intracranial lesions.
Conclusions:
- Histopathological validation is crucial for accurately interpreting HRMRI findings in intracranial atherosclerosis.
- HRMRI shows potential for characterizing plaque components and vulnerability, aiding in stroke risk assessment.
Abstract:
Intracranial atherosclerosis is one of the leading causes of ischemic stroke and occurs more commonly in patients of Asian, African or Hispanic origin than in Caucasians. Although the histopathology of intracranial atherosclerotic disease resembles extracranial atherosclerosis, there are some notable differences in the onset and severity of atherosclerosis. Current understanding of intracranial atherosclerotic disease has been advanced by the high-resolution magnetic resonance imaging (HRMRI), a novel emerging imaging technique that can directly visualize the vessel wall pathology. However, the pathological validation of HRMRI signal characteristics remains a key step to depict the plaque components and vulnerability in intracranial atherosclerotic lesions. The purpose of this review is to describe the histological features of intracranial atherosclerosis and to state current evidences regarding the validation of MR vessel wall imaging with histopathology.
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