Atherosclerotic Middle Cerebral Arteries On Vessel Wall Magnetic Resonance Imaging

Objective: To compare the use of 3.0T 3D vessel wall MRI(3D-VW-MRI)and DSA of the diagnosis of the middle cerebral artery(MCA)stenosis and discuss the clinical value of 3D-VW-MRI diagnosis of middle cerebral artery atherosclerotic stenosis.Methods: 46 patients of ischemic cerebrovascular disease were chosen.These patients received both 3.0T 3D-VW-MRI and DSA within 1 week.Comparison of 3D-VWMRI and DSA for the evaluation of the MCA atherosclerotic steno-occlusive and lesion length.Steno-occlusive were categorized as mild(0-49.9%),moderate(50-69.9%),severe(70-99.9%),or occlusive(no flow detected).The sensitivity,specificity,negative predictive value,positive predictive value,Spearman correlation analysis and Bland-Altman analysis were calculated using DSA as the golden standard.Results: Among 46 patients,there were 92 MCAs examined by 3D-VW-MRI and DSA.The sensitivity,specificity,positive predictive value,negative predictive value of mild degree MCA stenosis were 88.2%?92%?71.4% and 97.2%,respectively.In moderate stenosis were 60%?97.4%?81.8% and 92.6%,respectively.In severe stenosis were 78.6%?94.9%?73.3% and 96.1%,respectively.In occlusion were 100%?97.6%?83.3% and 100%.Positive correlation in measuring luminal stenosis(Spearman r=0.940)and lesion length(Spearman r=0.977)was found between 3D-VW-MRI and DSA.Bland-Altman analysis suggested good consistency of the two methods.Conclusions: The results of both 3D-VW-MRI and DSA showed a high coincidence of the two methods.With its fast acquisition and large coverage,3D-VW-MRI can become an alternative choice for MCA atherosclerosis disease.Objective: Using three-dimensional magnetic resonance wall imaging(3D-VW-MRI)to investigate the evaluation of plaque vulnerability by comparing the differences of atherosclerotic plaque features between symptomatic and asymptomatic sides.Methods: Patients with bilateral middle cerebral artery(MCA)stenosis but suffered from unilateral limb symptoms were collected.The plaque load on both sides of the plaque was measured to assess the plaque surface morphology signal features and enhancement characteristics.To compare the differences of middle cerebral artery plaque between symptomatic and asymptomatic sides.Results: 14 patients were enrolled in this study.Compared with asymptomatic side,symptomatic side had a higher incidence of the stenosis rate,wall area(WA),and normalized wall index(NWI),the difference was statistically significant(p<0.001).The difference of bilateral vascular area(VA)was not statistically significant(p=0.659).The luminal area(LA)of symptomatic side MCA was smaller than that of asymptomatic side,and the difference was statistically significant(p<0.001).Most of symptomatic and asymptomatic side plaques showed iso-intensity signal on T1 WI and Pd W-VISTA.Compared with asymptomatic side,plaque enhancement was more common on the symptomatic side after injection of contrast agent(p = 0.004),but the incidence of irregular plaques was not statistically significant(p = 0.5).Conclusions: 3D-VW-MRI showed that the MCA plaque on the symptomatic side was larger than that of the asymptomatic side,and the number of enhanced plaques was larger in MCA stenosis in patients with unilateral acute stroke.The characteristics of MCA plaque,Non-symptomatic side differences,help identify the responsibility of blood vessels,assess plaque vulnerability.Objective: Use three-dimensional magnetic resonance wall imaging 3D-VW-MRI technology to evaluate the effects of medical drug therapy on middle cerebral artery(MCA)stenosis and plaque morphology in the short term.Methods: 16 patients were enrolled in this study.Regular use of drugs(Tegrelol or clopidogrel,aspirin,combined with atorvastatin or rosuvastatin)for 3 months.Comparison of plaque stenosis and plaque characteristics before and after treatment.Results: There were no significant differences in the MCA stenosis,vascular area(VA),luminal area(LA),wall area(WA),and normalized wall index(NWI),before and after treatment(p = 0.767,0.621,0.559,0.155 and 0.384).The signal characteristics had no obvious change before and after treatment.Seven cases of enhanced plaque have reduced the degree of signal intensity or no significantly in the 3-month review.Conclusions: There was a trend toward a decrease of enhancement with time relative to the initial stroke presentation,showed that the use of internal medicine treatment might inhibit inflammatory reaction.There were no significant differences in plaque morphology and stenosis before and after drug treatment.