Strong enhancement on three-dimensional black-blood enhanced magnetic resonance imaging: Comparison intracranial
Myeongsuk Gang1, Hyunjin Lee1, Hyo Sung Kwak2
1Jeonbuk National University Medical School, Republic of Korea.
Insights
Three-dimensional black blood imaging reveals distinct contrast enhancement patterns in anterior intracranial artery occlusion and stenosis. These patterns aid in differentiating complete occlusion from varying degrees of stenosis, crucial for stroke evaluation.
Area of Science:
- Neuroradiology
- Vascular Neurology
- Medical Imaging
Background:
- Vascular imaging is critical for diagnosing cerebrovascular diseases.
- Accurate characterization of intracranial artery stenosis and occlusion is essential for patient management.
- Three-dimensional (3D) black blood (BB) contrast-enhanced magnetic resonance (MR) imaging offers detailed visualization of intracranial arteries.
Purpose of the Study:
- To evaluate contrast enhancement patterns on 3D BB contrast-enhanced MR imaging.
- To assess these patterns in patients with anterior intracranial artery occlusion or stenosis.
- To correlate imaging findings with the degree of arterial narrowing.
Main Methods:
- Retrospective review of 92 patients with positive findings on 3D BB contrast-enhanced MR imaging.
- Patients were categorized based on MR angiography findings: complete occlusion, high-grade stenosis (51-99%), or low-grade stenosis (10-50%).
- Analysis of contrast enhancement patterns, including concentric, segmental, and focal enhancement, and the high signal vessel sign.
Main Results:
- Complete occlusion (n=33) showed concentric and segmental enhancement.
- High-grade stenosis (n=36) frequently demonstrated concentric and focal enhancement.
- The high signal vessel sign was significantly higher in the occlusion group (p < 0.001), with a lower contrast ratio between the lesion and pituitary gland (p < 0.05).
Conclusions:
- Distinct contrast enhancement patterns on 3D BB contrast-enhanced MR imaging can differentiate between occlusion and stenosis.
- Bright contrast enhancement and high signal vessel sign are associated with contrast stagnation and slow flow at the occlusion site.
- These findings enhance the diagnostic utility of 3D BB contrast-enhanced MR imaging in anterior intracranial artery disease.
Purpose:
The purpose of this study was to evaluate contrast enhancement patterns on three-dimensional (3D) black blood (BB) contrast-enhanced magnetic resonance (MR) imaging in patients with occlusion or stenosis of the anterior intracranial artery.
Materials And Methods:
From January 2018 to January 2020 we retrospectively reviewed stroke 3D BB contrast-enhanced MR imaging and MR angiography findings of patients visiting the emergency room for evaluation of non-traumatic brain lesions. In total, 92 patients with positive findings on 3D BB contrast-enhanced MR imaging were enrolled in this study. We divided the enrolled group according to whether MR angiography findings suggested complete occlusion, high-grade stenosis (51-99 %), or low-grade stenosis (10-50 %).
Results:
Of 92 patients, 33 had complete occlusion in the anterior intracranial artery, 36 had high-grade stenosis, and 23 had low-grade stenosis. The complete occlusion group showed concentric and segmental enhancement on 3D BB enhanced MR imaging. The high-grade stenosis group frequently showed concentric and focal enhancement. The high signal vessel sign in the complete occlusion group was significantly higher compared to the stenosis group (p < 0.001). The contrast ratio between the lesion and pituitary gland in the occlusion group was significantly lower than that of the stenosis group (p < 0.05).
Conclusion:
Bright contrast enhancement and high signal vessel sign on 3D BB contrast enhanced MR imaging are related to contrast stagnation of the occlusion site and slow flow of a distal portion of the occlusion site.
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