Background
Magnetic resonance vessel wall imaging (VWI) techniques have been developed to assess
atherosclerotic plaques in intracranial arteries, which are a cardinal cause of ischemic
stroke. However, the clinical roles of plaque-related vulnerability and inflammation
remain unclear. Hence, we evaluated plaque characteristics using VWI of the proximal
middle cerebral artery (M1) in patients with acute ischemic stroke.
Methods
We prospectively examined 30 consecutive patients with acute noncardioembolic stroke
in the M1 territory using pre-/postcontrast T1-weighted (T1W) three-dimensional (3D)
VWI with a 3-Tesla scanner. The contrast ratio (CR) and contrast enhancement of the
plaques were measured bilaterally at M1.
Results
Plaques were identified in the bilateral M1s of all patients, and no substantial stenosis
existed. The M1 plaque CRs ipsilateral to the infarct (46.7%-67.9%) were significantly
higher than the plaque CRs on the contralateral side (34.3%-69.4%), particularly in
patients with lacunar infarcts (P < .01). In contrast, the occurrence of plaque enhancement was not different between
the ipsilateral (20.0%) and contralateral (16.7%) sides. Further, the CRs in the nonlacunar
group were significantly higher than the CRs in the lacunar group (P < .05), whereas enhanced plaques tended to be more frequent in the nonlacunar group,
but this difference was not significant (P = .09).
Conclusions
T1W 3D-VWI revealed that the signal intensity of M1 plaques was significantly higher
in the affected side and in nonlacunar-type infarcts of patients with acute stroke,
suggesting that unstable plaques in the M1 can cause stroke events presumably due
to atherothrombotic mechanisms.
Key Words
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Article info
Publication history
Published online: March 22, 2016
Accepted:
December 27,
2015
Received in revised form:
December 14,
2015
Received:
October 28,
2015
Footnotes
Disclosure Statement: M.M. and H.K. are employees of GE Healthcare.
Ethical Standards and Patient Consent: We declare that all human and animal studies have been approved by the institutional ethical committee (H24-156) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
Authors' contribution: T. Natori: Project development, Data collection, Data analysis, Manuscript writing; M. Sasaki: Project development, Helped manuscript writing; M. Miyoshi: Technical support; K. Ito: Data collection; H. Ohba: Data collection; H. Miyazawa: Data collection; S. Narumi: Data collection; H. Kabasawa: Technical support; T. Harada: Data collection; Y. Terayama: Project development, Helped manuscript writing.
Conflict of interest: The authors declare no conflict of interest associated with this manuscript.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.12.032
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
