Diffusion-weighted MR Imaging After Angioplasty or Angioplasty Plus Stenting of Arteries Supplying the Brain
Horst J. Jaegera,
Klaus D. Mathiasa,
Robert Dreschera,
Elke Hautha,
Georg Bockischa,
Eren Demirela and
Hans Martin Gisslera
a From the Department of Radiology, Staedtische Kliniken Dortmund, and the Department of Radiology und MikroTherapie, University Witten/Herdecke, Dortmund, Germany.
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FIG 1. Patient 2.
A, Stenosis of the cavernous part of the right ICA.
B, Result after percutaneous angioplasty (3.5-mm balloon). Note irregularity at the site of the percutaneous angioplasty.
C, Cross flow from the right ICA to the contralateral hemisphere (occlusion of the left ICA is not shown). Post-procedural diffusion-weighted images (6000/103; number of excitations, one) obtained with a diffusion sensitization level of b = 1000 s/mm2.
D, New ipsilateral lesion: <5 mm, middle cerebral artery cortical territory, parietal lobe (arrow).
E, New contralateral lesion: 5 to 10 mm, middle cerebral artery cortical territory, parietal lobe (arrow).
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FIG 2. Patient 5.
A, Aortic arch injection (early phase). Stenosis of the innominate artery with antegrade flow in the right carotid artery. (Retrograde flow in the right VA with subclavian steal in the late phase is not shown).
B, Result after stent implantation (balloon-expandable stent, 8 mm diameter) with antegrade flow in the right VA (arrows). Post-procedural diffusion-weighted images (6000/103; number of excitations, one) obtained with a diffusion sensitization level of b = 1000 s/mm2.
C, New ipsilateral lesion: 5 to 10 mm, PCA deep territory, thalamus (arrow).
D, New ipsilateral lesion: 15 mm, PCA cortical territory, occipital lobe (arrow).
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FIG 3. Patient 6.
A, Stenosis of left VA (occlusion of right VA is not shown).
B, Result after percutaneous angioplasty (3.5-mm balloon).
C, Left VA injection. Note the anterior inferior-posterior inferior cerebellar artery complex on the right side (arrow). Post-procedural diffusion-weighted images (6000/103; number of excitations, one) obtained with a diffusion sensitization level of b = 1000 s;clmm2.
D, New cerebellar lesions: 5 to 10 mm, superior cerebellar artery territory (arrows).
E, New cerebellar lesion: 20 mm, posterior inferior cerebellar artery territory (arrow).
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FIG 4. A, Aortic arch injection (early phase). Occlusion of the proximal part of the left SA.
B, Aortic arch injection (late phase). Retrograde flow in left VA with subclavian steal.
C, Result after stent implantation (balloon-expandable stent, 7 mm) with antegrade flow in left VA.
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