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Updated: Aug 20, 2025
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Wall characteristics of atherosclerotic middle cerebral arteries in patients with single or multiple infarcts: A
Zelan Ma1, Mengjuan Huo1, Jiajun Xie2
1Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Background And Purpose:
Understanding the stroke mechanism of middle cerebral artery (MCA) atherosclerosis may inform secondary prevention. The aim of this study was to explore the relationship between vascular wall characteristics and infarction patterns using high-resolution magnetic resonance imaging (HRMRI) and diffusion-weighted imaging (DWI).
Methods:
From November 2018 to March 2021, patients with acute ischemic stroke due to MCA atherosclerotic disease were retrospectively analyzed. The wall characteristics of atherosclerotic MCA, including conventional characteristics and histogram-defined characteristics, were evaluated using HRMRI. Patients were divided into single-infarction and multiple-infarction groups based on DWI, and wall characteristics were compared between the two groups.
Results:
Of 92 patients with MCA plaques, 59 patients (64.1%) had multiple infarcts, and 33 (35.9%) had single infarcts. The histogram-defined characteristics showed no differences between the single-infarction and multiple-infarction groups (P>0.05). Plaque burden, degree of stenosis, and prevalence of intraplaque hemorrhage (IPH) were significantly greater in the multiple-infarction group than in the single-infarction group (plaque burden: P = 0.001; degree of stenosis: P = 0.010; IPH: P = 0.019). Multivariate analysis showed that plaque burden (odds ratio: 1.136; 95% confidence interval: 1.054-1.224, P = 0.001) and IPH (odds ratio: 5.248; 95% confidence interval: 1.573-17.512, P = 0.007) were independent predictors for multiple infarction.
Conclusion:
IPH and plaque burden are independently associated with multiple infarcts. HRMRI may provide new insight into the mechanisms underlying the different MCA infarction patterns.
Insights
Intraplaque hemorrhage and plaque burden in middle cerebral artery atherosclerosis are linked to multiple strokes. High-resolution MRI can reveal these vascular wall characteristics, aiding in understanding stroke mechanisms.
Area of Science:
- Neurology
- Cardiovascular Imaging
- Cerebrovascular Disease
Background:
- Middle cerebral artery (MCA) atherosclerosis is a significant cause of ischemic stroke.
- Understanding stroke mechanisms is crucial for effective secondary prevention strategies.
Purpose of the Study:
- To investigate the association between vascular wall characteristics of MCA atherosclerotic plaques and stroke infarction patterns.
- To utilize high-resolution magnetic resonance imaging (HRMRI) and diffusion-weighted imaging (DWI) for this exploration.
Main Methods:
- Retrospective analysis of 92 patients with acute ischemic stroke due to MCA atherosclerotic disease.
- Evaluation of MCA plaque characteristics using HRMRI, including conventional and histogram-defined features.
- Comparison of vascular wall characteristics between patients with single versus multiple infarcts identified by DWI.
Main Results:
- Multiple infarcts (64.1%) were more common than single infarcts (35.9%) in the study cohort.
- Higher plaque burden, degree of stenosis, and prevalence of intraplaque hemorrhage (IPH) were significantly associated with multiple infarcts.
- Multivariate analysis identified plaque burden and IPH as independent predictors of multiple infarctions.
Conclusions:
- Intraplaque hemorrhage and plaque burden are independently associated with multiple infarcts in MCA atherosclerosis.
- HRMRI offers valuable insights into the mechanisms driving different MCA infarction patterns, potentially informing secondary stroke prevention.
