Related Experiment Video
Updated: Jul 23, 2025
Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
High-resolution magnetic resonance imaging of acute intracranial artery thrombus
Zong-Mu-Yu Zhang1, Qian-Qian Si1, Hui-Sheng Chen2
1Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background And Purpose:
The development of high-resolution magnetic resonance imaging (HR-MRI) has enabled submillimeter-level evaluation of intracranial artery plaque and luminal thrombus. We sought to investigate the value of HR-MRI in assessing the pathogenesis of acute intracranial artery thrombus.
Methods:
We examined the presence of intracranial thrombus on three-dimensional T1-weighted HR-MRI in acute ischemic stroke patients with intracranial artery occlusion on magnetic resonance angiography. We defined two thrombus-related HR-MRI features (peri-thrombus plaque and distal residual flow beyond the thrombus) and analyzed their association with potential embolic sources.
Results:
Luminal thrombus and a shrunken artery without luminal thrombus were detected in 162 (96.4%) and six (3.6%) of 168 patients with intracranial artery occlusion, respectively. Among 111 patients with culprit major artery thrombus, peri-thrombus plaques were observed in 46.8% and distal residual flow beyond the thrombus in 64.0%. Patients with peri-thrombus plaque had a higher prevalence of diabetes (44.2% vs. 25.4%; p = 0.037), a lower prevalence of potential sources of cardioembolism (0% vs. 16.9%; p = 0.002), and a nonsignificantly lower prevalence of potential embolic sources from extracranial arteries (9.6% vs. 20.3%; p = 0.186) than those without. Patients with distal residual flow beyond the thrombus had a lower prevalence of potential sources of cardioembolism (1.4% vs. 22.5%; p < 0.001) and smaller infarct volumes (5.0 [1.4-12.7] mL vs. 16.6 [2.4-94.6] mL; p = 0.012) than those without.
Conclusions:
Our study showed that HR-MRI helps clarify the pathogenesis of acute intracranial artery thrombus. The presence of peri-thrombus plaque and distal residual flow beyond the thrombus favor the stroke mechanism of atherosclerosis rather than cardioembolism.
Insights
High-resolution magnetic resonance imaging (HR-MRI) reveals features of intracranial artery plaque and thrombus. These findings help differentiate between atherosclerosis and cardioembolism as stroke causes.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Research
Background:
- High-resolution magnetic resonance imaging (HR-MRI) allows detailed visualization of intracranial artery plaque and thrombus.
- Understanding the pathogenesis of acute intracranial artery thrombus is crucial for effective stroke management.
Purpose of the Study:
- To investigate the utility of HR-MRI in elucidating the mechanisms underlying acute intracranial artery thrombus formation.
- To assess the association between HR-MRI identified thrombus features and potential embolic sources.
Main Methods:
- HR-MRI was used to examine intracranial thrombus in acute ischemic stroke patients with artery occlusion.
- Two key HR-MRI features were defined: peri-thrombus plaque and distal residual flow.
- These features were analyzed for their correlation with embolic sources.
Main Results:
- Luminal thrombus was detected in 96.4% of patients.
- Peri-thrombus plaques were found in 46.8% of major artery thrombi, associated with higher diabetes prevalence and lower cardioembolic risk.
- Distal residual flow was observed in 64.0%, linked to lower cardioembolic risk and smaller infarct volumes.
Conclusions:
- HR-MRI effectively clarifies the pathogenesis of acute intracranial artery thrombus.
- The presence of peri-thrombus plaque and distal residual flow suggests an atherosclerotic mechanism over cardioembolism.
- HR-MRI findings aid in distinguishing stroke etiologies.
More Related Videos
Related Concept Videos
01:24Magnetic Resonance Imaging
01:21Imaging Studies for Cardiovascular System IV: CMRI