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Contrast-Enhanced High-Resolution MRI for Evaluating Time Course Changes in Middle Cerebral Artery Plaques
Arata Abe1, Tetsuro Sekine2, Yuki Sakamoto1
1Department of Neurological Science, Graduate School of Medicine, Nippon Medical School.
Contrast-enhanced MRI effectively tracks changes in symptomatic middle cerebral artery (MCA) plaques over time. This method aids in evaluating plaque stability and predicting stroke recurrence risk in patients with MCA stenosis.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Imaging
Background:
- Symptomatic middle cerebral artery (MCA) stenosis poses a risk of recurrent stroke.
- Monitoring temporal changes in MCA plaque characteristics is crucial for risk stratification.
Purpose of the Study:
- To assess the feasibility of contrast-enhanced, high-resolution magnetic resonance imaging (MRI) for evaluating time-course changes in MCA stenotic plaques.
- To determine if MRI can detect changes in plaque stability related to stroke recurrence.
Main Methods:
- Contrast-enhanced, high-resolution 3D turbo spin-echo images with low refocusing flip angle control (3D LOWRAT) were acquired in 7 patients with symptomatic MCA stenosis.
- Imaging was performed at 1 month and 7 months post-stroke onset.
- Plaque-to-thalamus signal intensity ratio, degree of stenosis, and stroke recurrence were statistically analyzed and compared between time points.
Main Results:
- In 4 out of 7 patients, a decreased signal intensity ratio at follow-up suggested plaque changes.
- One patient showed subsequent improvement in stenosis.
- In 3 patients with unchanged signal intensity ratios, 2 experienced ischemic stroke, indicating potential plaque instability.
Conclusions:
- Gadolinium contrast enhancement using high-resolution MRI is a valuable tool for assessing temporal changes in the stability of symptomatic MCA stenotic plaques.
- MRI findings correlate with clinical outcomes, aiding in the evaluation of stroke risk.
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