Frequency and Pattern of MRI Diffusion Restrictions after Diagnostic Catheter Neuroangiography

Area of Science:

• Neuroradiology
• Cerebrovascular Imaging
• Interventional Neurology

Background:

• Diagnostic angiography is a common procedure for evaluating cerebrovascular diseases.
• Diffusion restrictions (DR) on MRI can indicate acute ischemic changes.
• The incidence and characteristics of asymptomatic DR after diagnostic angiography are not well-established.

Purpose of the Study:

• To determine the frequency, location, and size of diffusion restrictions (DR) in asymptomatic patients post-diagnostic angiography.
• To identify risk factors associated with the occurrence of these asymptomatic DR.
• To assess the safety and implications of diagnostic angiography regarding silent cerebral ischemia.

Main Methods:

• Analysis of diffusion-weighted images (DWI) from 344 asymptomatic patients within seven days of diagnostic angiography.
• Systematic review of MRI scans to identify and characterize diffusion restrictions (DR).
• Statistical analysis to correlate DR occurrence with patient demographics, medical history, and procedural parameters (contrast volume, fluoroscopy time).

Main Results:

• Asymptomatic diffusion restrictions (infarcts) were detected in 17% of patients (59 out of 344).
• A total of 167 lesions were identified, predominantly small (1-5 mm) and dot-shaped (97.6%).
• Significant risk factors for DR included older age, history of atherosclerosis, prior cerebral infarction, coronary heart disease, increased contrast volume, and longer fluoroscopy time.

Conclusions:

• Diagnostic angiography is associated with a notable risk of asymptomatic cerebral ischemia (17% incidence).
• The observed lesions are typically small, dot-shaped infarcts, often without immediate neurological deficits.
• The findings underscore the need for enhanced safety protocols to minimize silent embolic events during neuroangiography.