In vivo middle cerebral artery plaque imaging by high-resolution MRI

Klein, Isabelle; Lavallée, Philippa C.; Touboul, Pierre‐Jean; Schouman-Claeys, É.; Amarenco, Pierre

doi:10.1212/01.wnl.0000225074.47396.71

Cited by 116 publications

(93 citation statements)

References 7 publications

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“…10) Therefore, precise evaluation of arterial wall thickness using high resolution MR imaging is the most reliable modality for practical treatment and diagnosis. 9) This MR sequence was originally reported for detection of atherosclerotic plaque of intracranial artery, but is also useful to evaluate the arterial wall thickness. In the present case, 3-T MR plaque imaging demonstrated the luminal stenosis and thickened arterial wall without atherosclerotic plaque, which led us to the diagnosis of arteritis.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Arteritis With Extremely Late Onset Secondary to Bacterial Meningitis -Case Report-

Kawaguchi

Ogawa

Inoue

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 59-year-old woman presented with bacterial meningitis causing arterial narrowing in the very late stage. She initially underwent transsphenoidal surgery for massive non-functioning pituitary adenoma resulting in gross total removal. The postoperative course was uneventful, and she was discharged 12 days after surgery. Fourteen months later, she presented with bacterial meningitis due to streptococcus. Administration of multiple antibiotics resulted in normalization of cerebrospinal fluid findings. Forty days after meningitis onset, she suddenly suffered motor weakness of the right extremities. Magnetic resonance (MR) angiography revealed multiple intracranial arterial narrowings. Despite intensive treatment, no improvement of arterial narrowing was seen, and she suffered cerebral infarction. Six months after the onset of meningitis, MR angiography still showed multiple arterial narrowings, and MR plaque imaging of the stenotic vessel disclosed thickened arterial wall. This case illustrates the complex time course of arteritis caused by severe bacterial meningitis, and the intractability to treatment.

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Section: Discussionmentioning

confidence: 99%

Cerebral Arteritis With Extremely Late Onset Secondary to Bacterial Meningitis -Case Report-

Kawaguchi

Ogawa

Inoue

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…71,72 There are limitations to such a calculation because the use of a reference site is dependent on the tortuosity of the MCA and factors related to section selection such as the particular region of the MCA imaged and the imaging parameters, section spacing, and section thickness. One potential means of ascertaining the normal lumen measurement for a specific site of stenosis is to image the equivalent segment of the contralateral MCA as implied by others 73 ; this method is equally subject to artifact and, furthermore, presumes unilateral disease.…”

Section: Quantitative Assessment Of Plaque Burdenmentioning

confidence: 99%

“…71 Nevertheless, all of these quantitative assessments of plaque within the MCA are dependent on section thickness and, thereby, are subject to overestimation attributable to partial volume effects. 73 …”

Section: Quantitative Assessment Of Plaque Burdenmentioning

confidence: 99%

“…79 Enhancement could potentially be used to indicate the risk of plaque causing symptoms; however, an earlier study of just 6 patients with known MCA stenosis found that both asymptomatic and remotely symptomatic patients demonstrated gadolinium enhancement of plaque. 73 A bright arterial wall on unenhanced FLAIR T1 may be seen in acute hemorrhage or dissection of the MCA. 79 In 1 case study, bright T1 hyperintense signal intensity (relative to the adjacent pterygoid muscle) within an MCA plaque was seen in a recently symptomatic patient, implicating intraplaque hemorrhage as the likely cause of this patient's symptoms.…”

Section: Plaque Characterizationmentioning

confidence: 99%

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MR Angiography and Imaging for the Evaluation of Middle Cerebral Artery Atherosclerotic Disease

Degnan

Gallagher

Zhang

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY:Intracranial atherosclerotic disease may constitute the most common cause of ischemic stroke worldwide; yet, in the developed world, imaging research has largely focused on extracranial atherosclerosis. Many studies in populations of Asian, African, and Hispanic descent demonstrate the preponderance of intracranial stenosis compared with carotid stenosis. This review examines the clinical presentations of MCA atherosclerosis and stenosis and the use of noninvasive MR imaging in the assessment of intracranial vasculature. MRA is a well-validated technique that offers great advantage over traditional angiography. Advances in high-resolution MR imaging of MCA stenosis have the potential to yield excellent visualization of plaque. Future developments in high-resolution MR imaging to depict intracranial atherosclerosis are explored in this review; these advances will guide endovascular therapy and the comparison of novel interventions.ABBREVIATIONS: TOF ϭ time-of-flight; TCD ϭ transcranial Doppler S troke is a common cause of morbidity and mortality, with cerebrovascular disease constituting the second most frequent cause of death worldwide.1 While the burden of cerebrovascular disease in the developing world is receiving greater attention, its importance is underestimated.2 Intracranial atherosclerotic disease is reaching greater clinical prominence as potentially the greatest contributor to the burden of cerebrovascular disease worldwide.3 Previously, atherosclerotic disease within intracranial vessels was not well-appreciated clinically, perhaps due to the inability to visualize the MCA noninvasively or the greater emphasis on the more easily imaged carotid arteries. In an early study of MCA syndromes, Lhermitte et al 4 alleged that "atherosclerotic thrombosis of MCA is probably a rare event and the primary cause . . . lies in the proximal ICA . . . for an almost inaccessible artery appears to be of little significance." Thus, early investigations established a precedent of emphasizing extracranial atherosclerosis at the expense of investigation of other manifestations of cerebrovascular disease.In examining only extracranial disease, investigators may be detecting only advanced atherosclerosis. Some argue that MCA disease may precede extracranial atherosclerosis; this sequence is suggested by the lack of substantial carotid stenosis in a group of patients with intracranial atherosclerosis, while nearly all those with extracranial stenosis also had concomitant intracranial stenosis.5 Therefore, detecting intracranial atherosclerosis may enable clinicians to intervene earlier.There is much controversy about the degree of MCA stenosis responsible for stroke, with some groups arguing that MCA stenosis is not important in the white population on the basis of a small TCD sonography study.6 Yet a host of postmortem and imaging studies implicate MCA atherosclerosis as a likely cause of stroke.7-9 Further investigation is necessary to evaluate the prevalence and importance of MCA disease as an etiology of ischemic...

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“…4 In recent years, a few studies have attempted to characterize intracranial atherosclerotic plaque composition by in vivo MR imaging. [5][6][7][8][9] Intracranial plaque imaging with MR imaging has identified high-risk plaque correlated with infarct territory and plaque associated with stroke recurrence. [10][11][12][13] However, these studies have mostly focused on plaque enhancement to ascertain plaque risk.…”

mentioning

confidence: 99%

Identification and Quantitative Assessment of Different Components of Intracranial Atherosclerotic Plaque by Ex Vivo 3T High-Resolution Multicontrast MRI

Jiang

Peng²,

Tian³

et al. 2017

AJNR Am J Neuroradiol

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In vivo middle cerebral artery plaque imaging by high-resolution MRI

Cited by 116 publications

References 7 publications

Cerebral Arteritis With Extremely Late Onset Secondary to Bacterial Meningitis -Case Report-

Cerebral Arteritis With Extremely Late Onset Secondary to Bacterial Meningitis -Case Report-

MR Angiography and Imaging for the Evaluation of Middle Cerebral Artery Atherosclerotic Disease

Identification and Quantitative Assessment of Different Components of Intracranial Atherosclerotic Plaque by Ex Vivo 3T High-Resolution Multicontrast MRI

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