High-resolution magnetic resonance vessel wall imaging in cerebrovascular diseases

Rajendran, Adhithyan; Kesav, Praveen; Sylaja, PN; Kesavadas, Chandrasekharan

doi:10.4103/0028-3886.236964

Cited by 9 publications

(12 citation statements)

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“…HRVWI was performed as per previously published protocol from Sree Chitra Tirunal Institute for Medical sciences and technology, Trivandrum, India on a 3T Discovery system (GE Healthcare, Milwaukee, Wisconsin). 9 Acquired sequences (corresponding voxel resolution before interpolation, after interpolation) are shown as follows: sagittal Cube (GE Healthcare) T1 (0.8 Â 0.8 Â 1.4 mm, 0.3 Â 0.3 Â 1.4 mm), sagittal Cube T2 (0.6 Â 0.6 Â 1.2 mm, 0.3 Â 0.3 Â 1.2 mm), sagittal Cube proton density (0.6 Â 0.5 Â 1.2 mm, 0.3 Â 0.3 Â 1.2 mm). Interpolation was done by using zero-filling interpolation X 512 (matrix or in-plane) zero-filling interpolation X 2 (section or through-plane).…”

Section: Hrvwi Protocolmentioning

confidence: 99%

Vessel Wall Thickening and Enhancement in High-Resolution Intracranial Vessel Wall Imaging: A Predictor of Future Ischemic Events in Moyamoya Disease

Kathuveetil¹,

Sylaja²,

Senthilvelan

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Very few data are available with regard to high-resolution intracranial vessel wall imaging characteristics of Moyamoya disease and their relation to ischemic stroke risk. We investigated the high resolution imaging characteristics of MMD and its correlation with recent ischemic events. MATERIALS AND METHODS:Patients with Moyamoya disease confirmed by DSA, including patients after revascularization, were enrolled. All the patients underwent high-resolution intracranial vessel wall imaging. Vessel wall thickening, enhancement, and the remodeling index of the bilateral distal ICA and proximal MCA were noted. The patients were followed up at 3 months and 6 months after high-resolution intracranial vessel wall imaging and the association of ischemic events with imaging characteristics was assessed. RESULTS:Twenty-nine patients with Moyamoya disease were enrolled. The median age at symptom onset was 12 years (range, 1-51 years). A total of 166 steno-occlusive lesions were detected by high-resolution intracranial vessel wall imaging. Eleven lesions with concentric wall thickening (6.6%) were noted in 9 patients. Ten concentric contrast-enhancing lesions were observed in 8 patients, of which 3 patients (4 lesions) showed grade II enhancement. The presence of contrast enhancement (P 4 .01) and wall thickening (P # .001) showed a statistically significant association with ischemic events within 3 months before and after the vessel wall imaging. Grade II enhancement showed a statistically significant (P 4 .02) association with ischemic events within 4 weeks of high-resolution intracranial vessel wall imaging. The mean 6 standard deviation outer diameter of the distal ICA (right, À3.3 6 0.68 mm; left, 3.4 6 0.60 mm) and the remodeling index (right, 0.71 6 0.13; left, 0.69 6 0.13) were lower in Moyamoya disease. CONCLUSIONS:High-resolution intracranial vessel wall imaging characteristics of concentric wall thickening and enhancement are relatively rare in our cohort of patients with Moyamoya disease. The presence of wall thickening and enhancement may predict future ischemic events in patients with Moyamoya disease. ABBREVIATIONS: ACA 4 anterior cerebral artery; HRVWI 4 high-resolution intracranial vessel wall imaging; MMD 4 Moyamoya disease; PCA 4 posterior cerebral artery; SD 4 standard deviation Indicates open access to non-subscribers at www.ajnr.org http://dx.

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Section: Hrvwi Protocolmentioning

confidence: 99%

Vessel Wall Thickening and Enhancement in High-Resolution Intracranial Vessel Wall Imaging: A Predictor of Future Ischemic Events in Moyamoya Disease

Kathuveetil¹,

Sylaja²,

Senthilvelan

et al. 2020

AJNR Am J Neuroradiol

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“…HR-MRI can also reveal the relationship between the vessel wall and the surrounding tissues, further aiding clinicians in determining the location, number, shape, pathogenesis, and impact of the lesions. Studies have shown how HR-MRI provides details of the vessel walls required to determine whether there is a dissection or other internal vascular lesions such as moyamoya [4], which may not be visualized by DSA and CTA. DSA and CTA are not able to pick up an intramural hematoma, and typical imaging signs used with the DSA and CTA are not necessarily seen in all patients with an ICA dissection, such as an intimal flap and false lumen.…”

Section: High-resolution Magnetic Resonance Imagingmentioning

confidence: 99%

“…The pattern of the arterial dissection is presented clearly on the HR-MRI, with images of the intimal flap, double lumen, intramural hematoma, aneurysmal dilatation, tapered stenosis, and occlusion [10,11]. Compared with DSA and CTA, HR-MRI could enhance the diagnostic rate of carotid artery dissection and even identify diverse vascular diseases such as vasculitis or atherosclerosis [4,12]. Studies show that atherosclerotic plaques on HR-MRI show an eccentric growth and strengthening signal in the enhanced sequence and arteritis plaques show a concentric circle and strengthening signal in the enhanced sequence.…”

Section: High-resolution Magnetic Resonance Imagingmentioning

confidence: 99%

“…As a result, HR-MRI for use in detecting intracranial artery pathologies may be limited and insufficient [10]. Researchers reported that compared with plain scan HR-MRI, 3D HR-MRI provides a more comprehensive understanding of vessel walls [4,14,17]. Determining the best imaging technique to view intracranial vessels is still under investigation, but studies and case reports using HR-MRI for detecting extracranial vessel pathologies offer successful results.…”

Section: High-resolution Magnetic Resonance Imagingmentioning

confidence: 99%

“…To effectively treat patients, information on the pathological nature of the vessel wall is needed. More recently, High resolution-MRI (HR-MRI) has been of great diagnostic value in the diagnosis of cranial carotid artery lesions compared with other imaging modalities, as it can determine the nature of the vessel wall [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Rapid Diagnosis of Carotid Intramural Hematoma with HR-MRI

Peng¹,

Wang²,

Fu³

et al. 2018

Intern Med

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Carotid intramural hematoma, a type of carotid artery dissection, is hard to detect with traditional imaging examinations including color ultrasonography, computed tomography angiography (CTA), and digital subtraction angiography (DSA) because of the unaffected tunica intima. In this article, we report and discuss two cases of carotid intramural hematoma. In the first case, the patient experienced sudden-onset dysarthria with difficulty chewing and sucking. The diagnosis of ischemic stroke was further supported with the clinical presentation, physical examination, and a head CT scan. Later, the head and neck CTA examination detected the left carotid vessel had an irregular vascular wall and luminal stenosis, which was ultimately confirmed as intramural hematoma after performing neck high-resolution MRI (HR-MRI). Another patient was rapidly diagnosed with acute ischemic stroke using a head MRI scan, but the qualitative nature of the responsible vessel could not be distinguished by CTA and DSA. They could only demonstrate full occlusion of the carotid artery. HR-MRI was needed to identify the intramural hematoma-type ICA dissection. In conclusion, compared with CTA and DSA, HR-MRI is a cost-effective imaging examination with high resolution and easy repeatability. It can more accurately determine the nature of the vascular wall, the relationship of vessels and surrounding tissues, and effectively assists in the clinical judgement for intramural hematoma and other atypical carotid artery dissections.

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Utility of intracranial high-resolution vessel wall magnetic resonance imaging in differentiating intracranial vasculopathic diseases causing ischemic stroke

et al. 2019

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High-resolution magnetic resonance vessel wall imaging in cerebrovascular diseases

Cited by 9 publications

References 0 publications

Vessel Wall Thickening and Enhancement in High-Resolution Intracranial Vessel Wall Imaging: A Predictor of Future Ischemic Events in Moyamoya Disease

Vessel Wall Thickening and Enhancement in High-Resolution Intracranial Vessel Wall Imaging: A Predictor of Future Ischemic Events in Moyamoya Disease

Rapid Diagnosis of Carotid Intramural Hematoma with HR-MRI

Utility of intracranial high-resolution vessel wall magnetic resonance imaging in differentiating intracranial vasculopathic diseases causing ischemic stroke

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