Early experience in high-resolution MRI for large vessel occlusions

Abstract

HRMRI of vascular occlusions can identify wall characteristics and characterize the course and caliber of the vasculature distal to the occluded segment. This information may be useful in determining preferred approaches for endovascular revascularization.

Comparison of High-Resolution MR Imaging and Digital Subtraction Angiography for the Characterization and Diagnosis of Intracranial Artery Disease

“…Although the higher interobserver diagnostic agreement and the lower proportions of undetermined diagnoses were unclear as to their statistical significance and may not indicate higher diagnostic performance, HR-MR may not only be a useful imaging technique regarding the diagnosis but may also contribute to solving problem cases on luminal angiography due to the additional information beyond the luminal characterization. Hui et al 13 also postulated that DSA is inferior to HR-MR in vessel wall evaluation, though stenosis and occlusion may appear similar in all kinds of ICADs. Although DSA is still the criterion standard in ICAD, other types of luminal angiography, such as CTA and MRA with their minimal invasiveness, have widened the scope because DSA is an invasive study with complication risks, including morbidity and mortality.…”

“…Only a few studies have attempted to reveal the usefulness of HR-MR compared with DSA. 8,13,18,23 However, these observations were limited regarding only single vascular pathology (atherosclerosis, Moyamoya disease) or single cerebral artery (middle cerebral artery, basilar artery) or the small patient sample size (n ϭ 9). In particular, although these studies acknowledged that HR-MR presents additional information, such as the direct depiction of vessel walls beyond the luminal evaluation, HR-MR was evaluated by using DSA as the reference standard.…”

“…Only a few studies presented a comparison or correlation between DSA and HR-MR, 8,13,23 and these studies showed a good correlation regarding the degree of stenosis 8,23 and HR-MR features beyond DSA. 13 However, the observations were based on single vascular pathology or a single cerebral artery (middle cerebral artery, basilar artery) or a small sample size (n ϭ 9). In our study, we compared HR-MR with DSA in the characterization and diagnosis of various ICADs.…”

“…12,13 Although HR-MR evaluates and differentiates various ICADs with the direct depiction of arterial walls and multicontrast images 6,[14][15][16][17][18][19][20] that may correlate with luminal angiography, 8,21,22 the usefulness and value of HR-MR compared with luminal angiography are still unclear. Only a few studies presented a comparison or correlation between DSA and HR-MR, 8,13,23 and these studies showed a good correlation regarding the degree of stenosis 8,23 and HR-MR features beyond DSA. 13 However, the observations were based on single vascular pathology or a single cerebral artery (middle cerebral artery, basilar artery) or a small sample size (n ϭ 9).…”

Intracranial vessel wall MRI: a review of current indications and future applications

“…1) Compared to time-of-flight (TOF) MRA, which measures degree of stenosis, IVWM is able to characterize multiple imaging features of intracranial plaque [21] and has been more sensitive for the identification of symptomatic atherosclerotic lesions [5]. IVWM is also helpful to identify the morphology of intracranial vessels at [22] or distal [23] to an arterial occlusion, lesions , showing a lateral view of the atherosclerotic stenosis at the vertebrobasilar junction. d Diffusion-weighted image and apparent diffusion coefficient axial images of a second patient who presented with left-sided weakness and was found to have an acute ischemic stroke in the right internal capsule (white arrows).…”