Article Figures & Data
Figures
- Fig 1.
Comprehensive imaging of a patient with recent stroke depicting left MCA stenosis. A−G, DSA (A) confirms contrast-enhanced MRA (B) and volume-reduced TOF MRA (C) findings of severe stenosis within the right MCA in a recently symptomatic patient with small ischemic lesions seen on T2 (D and E) and FLAIR (F and G). MRA (B and C) overestimates the degree of stenosis in this particular case.
- Fig 2.
Multicontrast high-resolution MR imaging of a normal MCA. Sagittal high-resolution MR imaging of the MCA in a healthy volunteer demonstrates the ability of multiple sequences to depict the arterial wall and lumen in detail.
- Fig 3.
Multispectral high-resolution MR imaging of a symptomatic patient with MCA disease. T2-weighted (A and B), spin-echo inversion recovery (C and D), T1-weighted (E and F), and postgadolinium T1-weighted (G and H) images depict a large eccentric contrast-enhancing plaque within the lumen of a recently symptomatic patient on the ipsilateral side of symptom presentation.
Tables
- Table 1:
Plaque characteristics on multiple contrast weightings based on carotid imaging literature84,89–91
Plaque Characteristic TOF MRA T1-Weighted PD-Weighted T2-Weighted Fibrous cap Isointense/hypointense Isointense Isointense/hyperintense Hyperintense Lipid-rich necrotic core Isointense Isointense/hyperintense Hyperintense Hypointense Hemorrhage Hyperintense Hyperintense to hypointense (with age of hemorrhage) Hypointense to hyperintense Hypointense to hyperintense Calcification Hypointense Hypointense Hypointense Hypointense Note:—PD indicates proton attenuation.
Study Population Field Strength Findings Swartz et al (2009)79 37 Patients with focal neurologic deficits 3T Enhancing eccentric plaque in patients with intracranial atherosclerotic disease Xu et al (2010)71 26 Symptomatic and 28 asymptomatic patients with MCA stenosis 3T Symptomatic patients had larger wall area and expansive remodeling Li et al (2009)77 48 Patients with suspected MCA disease 3T High-resolution MR imaging can visualize plaque not seen with MRA Niizuma et al.(2008)70 3 Patients with perforator infarcts 3T High-resolution T2-weighted images detected a thin plaque that did not demonstrate stenosis on MRA Klein et al (2006)73 6 Patients with documented high-grade MCA stenosis 1.5T Focal arterial wall thickening is seen on high-resolution MR imaging of patients with previously identified MCA stenosis
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