Differentiation of Deep Subcortical Infarction Using High-Resolution Vessel Wall MR Imaging of Middle Cerebral Artery

• Published in: Korean journal of radiology 2017, 18(6), , pp.964-972
• Main Authors: Bae, Yun Jung, Choi, Byung Se, Jung, Cheolkyu, Yoon, Yeon Hong, Sunwoo, Leonard, Bae, Hee-Joon, Kim, Jae Hyoung
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Atherosclerosis; Cardiovascular disease; Cerebral Infarction - diagnosis; Cerebral Infarction - diagnostic imaging; Cerebral Infarction - pathology; Chi-square test; Chronic Disease; Constriction, Pathologic; Embolisms; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Angiography; Magnetic resonance imaging; Male; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - physiopathology; Neuroimaging and Head & Neck; Pathogenesis; Plaque, Atherosclerotic; Retrospective Studies; Stroke; Vein & artery diseases; 방사선과학
• ISSN: 1229-6929; 2005-8330
• DOI: 10.3348/kjr.2017.18.6.964

To evaluate the utility of high-resolution vessel wall imaging (HR-VWI) of middle cerebral artery (MCA), and to compare HR-VWI findings between striatocapsular infarction (SC-I) and lenticulostriate infarction (LS-I). This retrospective study was approved by the Institutional Review Board, and informed consent was waived. From July 2009 to February 2012, 145 consecutive patients with deep subcortical infarctions (SC-I, n = 81; LS-I, n = 64) who underwent HR-VWI were included in this study. The degree of MCA stenosis and the characteristics of MCA plaque (presence, eccentricity, location, extent, T2-high signal intensity [T2-HSI], and plaque enhancement) were analyzed, and compared between SC-I and LS-I, using Fisher's exact test. Stenosis was more severe in SC-I than in LS-I ( = 0.040). MCA plaque was more frequent in SC-I than in LS-I ( = 0.028), having larger plaque extent ( = 0.001), more T2-HSI ( = 0.001), and more plaque enhancement ( = 0.002). The eccentricity and location of the plaque showed no significant difference between the two groups. Both SC-I and LS-I have similar HR-VWI findings of the MCA plaque, but SC-I had more frequent, larger plaques with greater T2-HSI and enhancement. This suggests that HR-VWI may have a promising role in assisting the differentiation of underlying pathophysiological mechanism between SC-I and LS-I.