Atherosclerosis

2021

DOI: 10.1016/j.atherosclerosis.2021.01.002

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Acute ischemic stroke versus transient ischemic attack: Differential plaque morphological features in symptomatic intracranial atherosclerotic lesions

¹

,

Matthew M. Padrick

²

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³

et al.

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Plaque Signal Characteristics1

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Cited by 19 publications

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“…IPH: the most sensitive sequence for IPH is T1WI (see Figure 3). IPH generally shows hyperintensity on T1WI and hypo/hyperintensity on T2WI, but the signal of plaque hemorrhage is complex and is correlated with the timing of the hemorrhage (44). IPH is generally considered a biological feature of plaque instability.…”

Section: Plaque Signal Characteristicsmentioning

confidence: 99%

Application and interpretation of vessel wall magnetic resonance imaging for intracranial atherosclerosis: a narrative review

Li¹,

Wang²,

Hu³

et al. 2022

Ann Transl Med

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Background and Objective: Atherosclerosis is a systemic disease that occurs in the arteries, and it is the most important causative factor of ischemic stroke. Vessel wall magnetic resonance imaging (VWMRI) is one of the best non-invasive methods for displaying the vascular features of intracranial atherosclerosis. The main clinical applications of this technique include the exploration of the pathogenesis of intracranialatherosclerotic lesions, follow-up monitoring, and treatment prognosis judgment. As the demand for intracranial VWMRI increases in clinical practice, radiologists should be aware of the selection of imaging parameters and how they affect image quality, clinical indications, evaluation methods, and limitations in interpreting these images. Therefore, this review focused on describing how to perform and interpret VWMRI of intracranial atherosclerotic lesions. Methods: We searched the studies on the application of VWMRI in the PubMed database from January 1, 2000 to March 31, 2022, and focused on the analysis of related studies on VWMRI in atherosclerotic lesions, including technical application, expert consensus, imaging characteristics, and the clinical significance of intracranial atherosclerotic lesions.

“…IPH: the most sensitive sequence for IPH is T1WI (see Figure 3). IPH generally shows hyperintensity on T1WI and hypo/hyperintensity on T2WI, but the signal of plaque hemorrhage is complex and is correlated with the timing of the hemorrhage (44). IPH is generally considered a biological feature of plaque instability.…”

Section: Plaque Signal Characteristicsmentioning

confidence: 99%

Application and interpretation of vessel wall magnetic resonance imaging for intracranial atherosclerosis: a narrative review

Li¹,

Wang²,

Hu³

et al. 2022

Ann Transl Med

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Background and Objective: Atherosclerosis is a systemic disease that occurs in the arteries, and it is the most important causative factor of ischemic stroke. Vessel wall magnetic resonance imaging (VWMRI) is one of the best non-invasive methods for displaying the vascular features of intracranial atherosclerosis. The main clinical applications of this technique include the exploration of the pathogenesis of intracranialatherosclerotic lesions, follow-up monitoring, and treatment prognosis judgment. As the demand for intracranial VWMRI increases in clinical practice, radiologists should be aware of the selection of imaging parameters and how they affect image quality, clinical indications, evaluation methods, and limitations in interpreting these images. Therefore, this review focused on describing how to perform and interpret VWMRI of intracranial atherosclerotic lesions. Methods: We searched the studies on the application of VWMRI in the PubMed database from January 1, 2000 to March 31, 2022, and focused on the analysis of related studies on VWMRI in atherosclerotic lesions, including technical application, expert consensus, imaging characteristics, and the clinical significance of intracranial atherosclerotic lesions.

“…Studies have shown that vessel wall magnetic resonance imaging (VWMRI) is an effective tool for evaluating the wall features of ICAD (5)(6)(7). Research has reported that plaque characteristics such as contrast enhancement, intraplaque hemorrhage, wall remodeling, and plaque morphological features are strongly associated with stroke occurrence (8)(9)(10)(11); however, these studies were largely cross-sectional. As atherosclerosis is a dynamic process, longitudinal studies are needed to further elucidate the evolution of plaque features and their association with recurrent events.…”

Section: Introductionmentioning

confidence: 99%

Temporal changes in plaque characteristics after treatment and their relationship with stroke recurrence: a quantitative study using magnetic resonance imaging

Shen¹,

Ren²,

Wu³

et al. 2022

Quant Imaging Med Surg

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Background: Intracranial atherosclerotic disease (ICAD) is the major cause of ischemic stroke. Despite aggressive medical therapy, around 15% of patients with ICAD experience recurrence. The aim of the present study was to evaluate the temporal changes in intracranial arteriosclerotic plaques after medical treatment based on vessel wall magnetic resonance imaging (VWMRI) and to explore their relationship with stroke recurrence.Methods: A total of 67 symptomatic patients with ICAD who underwent initial and follow-up VWMRI were recruited into this retrospective cohort study. Stroke recurrence was defined as an ipsilateral stroke symptom after the initial attack. The clinical characteristics and plaque features, including stenosis ratio (measured based on luminal diameter or area), plaque thickness, plaque burden (PB), enhancement ratio (ER), and enhancement grade, were evaluated and compared between the initial and follow-up examinations.Changes in plaque characteristics were compared between patients with or without recurrence by univariable analyses. Multivariable regression was performed to investigate imaging markers for recurrent stroke. Results:The median interval between baseline and follow-up VWMRI was 334 days. A total of 13 cases (19.4%) experienced a stroke recurrence. After treatment, significant decreases in the stenosis ratio (area), PB, and ER were observed in cases without recurrence (all P<0.05), while no significant difference in plaque features was found for cases with recurrence. Univariable analyses showed that changes in stenosis ratio (area), plaque thickness, PB, and ER were significantly different between patients with and without recurrence (all P<0.05). Multivariable regression indicated that PB change was the only significant marker associated with stroke recurrence [odds ratio (OR) =1.112 per 1% increase, 95% confidence interval (CI): 1.010 to 1.224, P=0.031].Conclusions: Patients with arteriosclerotic plaques who benefit from medical treatment show obvious decreases in stenosis (area), PB, and ER. The progression of PB may serve as an independent marker for predicting stroke recurrence.

“…Further, with the advent of high-resolution vessel wall imaging (HR-VWI), it appears that the clinical status of MRA in the assessment of ICAD has been challenged. HR-VWI can clearly and directly display the vessel wall and its lesions, more visually evaluate the structural characteristics of the diseased vessel, diagnose the type of vascular lesion responsible for stroke, predict the risk of stroke caused by the diseased vessel, and provide a more accurate imaging tool for clinical diagnosis, treatment and prognostic assessment [7,8]. HR-VWI is being increasingly used as a diagnostic tool in daily practice.…”

mentioning

confidence: 99%

Evaluation of intracranial artery stenosis using time-of-flight magnetic resonance angiography: new wine in an old bottle

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,

²

2022

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Points• TOF MRA is very important in the evaluation of cerebrovascular stenosis, and a novel evaluation system can further enhance its strengths. • This evaluation system is more accurate based on the fact that cerebral vascular stenosis alters hemodynamics and leads to different imaging presentations.

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