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Ischemic stroke Plaque MR

J S McNally, T M Burton, B W Aldred, S-E Kim, M S McLaughlin, L B Eisenmenger, G J Stoddard, J J Majersik, D V Miller, G S Treiman, D L Parker
BACKGROUND AND PURPOSE: MR imaging-detected carotid intraplaque hemorrhage indicates vulnerable plaque with high stroke risk. Angiotensin II stimulates intraplaque hemorrhage in animal models, and the angiotensin system is highly regulated by vitamin D. Our purpose was to determine whether low vitamin D levels predict carotid intraplaque hemorrhage in humans. MATERIALS AND METHODS: In this cross-sectional study, 65 patients with carotid disease underwent carotid MR imaging and blood draw...
June 16, 2016: AJNR. American Journal of Neuroradiology
Xin Xu, Yafen Wei, Xiandong Zhang, Lili Yang, Zhitang Cui, Junjie Yan
PURPOSE: To investigate the correlation between middle cerebral atherosclerosis and capsular warning syndrome (CWS) and assess the value of higher-resolution magnetic resonance imaging (MRI) in prognostication. MATERIALS AND METHODS: In all, 97 transient ischemic attack (TIA) patients who underwent an MRI from February 2010 to December 2013 were included in the retrospective study and divided into either a CWS or middle cerebral artery (MCA) TIA group according to their eventual clinical diagnosis...
April 15, 2016: Journal of Magnetic Resonance Imaging: JMRI
Fabienne Perren, Maria I Vargas, Odysseas Kargiotis
BACKGROUND: In order to differentiate between the different causes of intracranial stenosis, we compared the diagnostic results of transcranial color-coded duplex (TCCD) sonography with the recently developed 3D high-resolution black blood MR sequence. METHODS: We studied retrospectively 20 patients referred to our hospital after acute ischemic stroke who were diagnosed with intracranial stenosis and in whom a repetitive TCCD and a 3D MR T1 FAT SAT (black blood) sequence at 3T (TR/TE 350/20 ms, FOV 160×182×120 mm, 0...
July 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Xiao-Dong Zou, Yiu-Cho Chung, Lei Zhang, Ying Han, Qi Yang, Jianping Jia
PURPOSE: Conventional two-dimensional vessel wall imaging has been used to depict the middle cerebral artery (MCA) wall in patients with recent small subcortical infarctions (RSSIs). However, its clinical use has been limited by restricted spatial coverage, low signal-to-noise ratio (SNR), and long scan time. We used a novel three-dimensional high-resolution MR imaging (3D HR-MRI) technique to investigate the presence, locations, and contrast-enhanced patterns of MCA plaques and their relationship with RSSI...
2015: BioMed Research International
A C van Dijk, M T B Truijman, B Hussain, T Zadi, G Saiedie, A A J de Rotte, M I Liem, A F W van der Steen, M J A P Daemen, P J Koudstaal, P J Nederkoorn, J Hendrikse, M E Kooi, A van der Lugt
BACKGROUND AND PURPOSE: An important characteristic of vulnerable plaque, intraplaque hemorrhage, may predict plaque rupture. Plaque rupture can be visible on noninvasive imaging as a disruption of the plaque surface. We investigated the association between intraplaque hemorrhage and disruption of the plaque surface. MATERIALS AND METHODS: We selected the first 100 patients of the Plaque At RISK study, an ongoing prospective noninvasive plaque imaging study in patients with mild-to-moderate atherosclerotic lesions in the carotid artery...
November 2015: AJNR. American Journal of Neuroradiology
Waleed Brinjikji, John Huston, Alejandro A Rabinstein, Gyeong-Moon Kim, Amir Lerman, Giuseppe Lanzino
Carotid artery stenosis is a well-established risk factor of ischemic stroke, contributing to up to 10%-20% of strokes or transient ischemic attacks. Many clinical trials over the last 20 years have used measurements of carotid artery stenosis as a means to risk stratify patients. However, with improvements in vascular imaging techniques such as CT angiography and MR angiography, ultrasonography, and PET/CT, it is now possible to risk stratify patients, not just on the degree of carotid artery stenosis but also on how vulnerable the plaque is to rupture, resulting in ischemic stroke...
January 2016: Journal of Neurosurgery
Ajay Gupta, Hediyeh Baradaran, Edward E Mtui, Hooman Kamel, Ankur Pandya, Ashley Giambrone, Costantino Iadecola, Pina C Sanelli
BACKGROUND: Carotid plaque MRI has been a useful method to characterize vulnerable atherosclerotic plaque elements. Recent investigations have suggested that source images from CT angiography (CTA) and MR angiography (MRA) can identify the simple high-risk features of symptom-producing carotid artery plaque. We studied the correlation and relative diagnostic accuracies of CTA and MRA source images in detecting symptomatic carotid artery plaque. METHODS: Subjects were eligible if they had carotid stenosis between 50 and 99% and had MRA and CTA exams performed within 10 days of one another...
2015: Cerebrovascular Diseases
Kojiro Wada, Hirohiko Arimoto, Naoki Ootani, Hideo Osada, Arata Tomiyama, Satoshi Tomura, Hideo Ueno, Kazuya Fujii, Kimihiro Nagatani, Satoru Takeuchi, Kentaro Mori
Symptomatic cervical carotid artery stenosis is one of the common causes of ischemic stroke in octogenarians. The records for 90 consecutive patients with symptomatic cervical carotid artery stenosis treated by carotid endarterectomy(CEA)were analyzed retrospectively. The patients were divided into two groups:21 patients aged 80 years or over and 69 patients aged less than 80 years. CT angiography revealed that ulcer formation was significantly more common and the length of carotid artery stenosis was significantly greater in the octogenarians...
December 2014: No Shinkei Geka. Neurological Surgery
C-W Ryu, G-H Jahng, H S Shin
BACKGROUND AND PURPOSE: High-resolution MR imaging can depict intracranial arterial atherosclerotic plaques. Our aim was to evaluate the relationship between the degree of enhancement of MCA plaques on contrast-enhanced high-resolution MR imaging and ischemic stroke and stenosis severity. MATERIALS AND METHODS: This study enrolled 36 patients diagnosed with moderate-to-severe atherosclerotic MCA stenosis. A contrast-enhanced T1-weighted volume isotropic turbo spin-echo acquisition sequence was acquired for assessing plaque enhancement...
December 2014: AJNR. American Journal of Neuroradiology
Ye Qiao, Steven R Zeiler, Saeedeh Mirbagheri, Richard Leigh, Victor Urrutia, Robert Wityk, Bruce A Wasserman
PURPOSE: To characterize intracranial plaque inflammation in vivo by using three-dimensional (3D) high-spatial-resolution contrast material-enhanced black-blood (BB) magnetic resonance (MR) imaging and to investigate the relationship between intracranial plaque inflammation and cerebrovascular ischemic events. MATERIALS AND METHODS: The study was approved by the institutional review board and was HIPAA compliant. Twenty-seven patients (19 men; mean age, 56.8 years ± 12...
May 2014: Radiology
A Jaberi, C Lum, P Stefanski, R Thornhill, D Iancu, W Petrcich, F Momoli, C Torres, D Dowlatshahi
INTRODUCTION: Filling defects at the internal carotid artery (ICA) origin in the work-up of stroke or transient ischemic attack may be an ulcerated plaque or free-floating thrombus (FFT). This may be challenging to distinguish, as they can appear morphologically similar. This is an important distinction as FFT can potentially embolize distally, and its management differs. We describe a series of patients with suspected FFT and evaluate its imaging appearance, clinical features, and evolution with therapy...
January 2014: Neuroradiology
Yasushi Okada
Since transient ischemic attack (TIA) is regarded as a medical emergency with high risk for early stroke recurrence, the underlying mechanisms should be immediately clarified to conclude a definitive diagnosis and provide early treatment. Early risk stratification using ABCD(2) scores can predict the risk of ischemic stroke occurring after TIA. Carotid ultrasonography (US) can evaluate the degree of stenosis, plaque properties and flow velocity of ICA lesions. High-risk mobile plaques can be classified by carotid US, and aortogenic sources of emboli can be detected by transesophageal echocardiography...
2014: Frontiers of Neurology and Neuroscience
Marcus R Makowski, René M Botnar
Cardiovascular diseases remain the leading cause of morbidity and mortality in the Western world and developing countries. In clinical practice, in vivo characterization of atherosclerotic lesions causing myocardial infarction, ischemic stroke, and other complications remains challenging. Imaging methods, limited to the assessment luminal stenosis, are the current reference standard for the assessment of clinically significant coronary and carotid artery disease and the guidance of treatment. These techniques do not allow distinction between stable and potentially vulnerable atherosclerotic plaque...
October 2013: Radiology
A Gupta, H Baradaran, H Kamel, A Mangla, A Pandya, V Fodera, A Dunning, P C Sanelli
BACKGROUND AND PURPOSE: Intraplaque hemorrhage in carotid artery atherosclerotic plaque has been shown to be a marker of risk, associated with prior and future ischemic events, and has been associated with regions of intraplaque high-intensity signal on 3D-TOF MRA. We assessed the association of intraplaque high-intensity signal determined on 3D-TOF MRA with the incidence of prior ipsilateral stroke or TIA. MATERIALS AND METHODS: We assessed intraplaque hemorrhage by evaluating for intraplaque high-intensity signal adapting a recently validated technique on 3D-TOF source images in participants with high-grade (≥ 70%) extracranial carotid stenosis...
March 2014: AJNR. American Journal of Neuroradiology
Lorena Esposito-Bauer, Tobias Saam, Iman Ghodrati, Jaroslav Pelisek, Peter Heider, Matthias Bauer, Petra Wolf, Angelina Bockelbrink, Regina Feurer, Dominik Sepp, Claudia Winkler, Peter Zepper, Tobias Boeckh-Behrens, Matthias Riemenschneider, Bernhard Hemmer, Holger Poppert
PURPOSE: The aim of this study was to investigate prospectively whether MRI plaque imaging can identify patients with asymptomatic carotid artery stenosis who have an increased risk for future cerebral events. MRI plaque imaging allows categorization of carotid stenosis into different lesion types (I-VIII). Within these lesion types, lesion types IV-V and VI are regarded as rupture-prone plaques, whereas the other lesion types represent stable ones. METHODS: Eighty-three consecutive patients (45 male (54...
2013: PloS One
M Trelles, K M Eberhardt, M Buchholz, A Schindler, A Bayer-Karpinska, M Dichgans, M F Reiser, K Nikolaou, T Saam
BACKGROUND AND PURPOSE: High-resolution carotid MR imaging can accurately identify complicated American Heart Association lesion type VI plaques, which are characterized by thrombus, hemorrhage, or a ruptured fibrous cap. The purpose of this study is to evaluate whether CTA can be used as screening tool to predict the presence or absence of American Heart Association lesion type VI plaques as defined by high-resolution MR imaging. METHODS: Fifty-one patients with suspected ischemic stroke or TIA with carotid CTA and carotid MR imaging performed within 14 days of the event/admission from April 2008 to December 2010 were reviewed...
December 2013: AJNR. American Journal of Neuroradiology
P Vakil, J Vranic, M C Hurley, R A Bernstein, A W Korutz, A Habib, A Shaibani, F H Dehkordi, T J Carroll, S A Ansari
BACKGROUND AND PURPOSE: Contrast enhancement of intracranial atherosclerotic plaques has recently been investigated using high field and high resolution MR imaging as a risk factor in the development of ischemic stroke. We studied the reliability of conventional MR imaging at 1.5T in evaluating intraplaque enhancement and its relationship with acute cerebrovascular ischemic presentations in patients with severe intracranial atherosclerotic disease. MATERIALS AND METHODS: We retrospectively identified and analyzed 19 patients with 22 high-grade intracranial atherosclerotic disease plaques (>70% stenosis) in vessels cross-sectionally visualized by neuroanatomic MR imaging...
December 2013: AJNR. American Journal of Neuroradiology
Jochen M Grimm, Andreas Schindler, Tobias Freilinger, Clemens C Cyran, Fabian Bamberg, Chun Yuan, Maximilian F Reiser, Martin Dichgans, Caroline Freilinger, Konstantin Nikolaou, Tobias Saam
BACKGROUND: To determine if black-blood 3 T cardiovascular magnetic resonance (bb-CMR) can depict differences between symptomatic and asymptomatic carotid atherosclerotic plaques in acute ischemic stroke patients. METHODS: In this prospective monocentric observational study 34 patients (24 males; 70 ±9.3 years) with symptomatic carotid disease defined as ischemic brain lesions in one internal carotid artery territory on diffusion weighted images underwent a carotid bb-CMR at 3 T with fat-saturated pre- and post-contrast T1w-, PDw-, T2w- and TOF images using surface coils and Parallel Imaging techniques (PAT factor = 2) within 10 days after symptom onset...
2013: Journal of Cardiovascular Magnetic Resonance
Huilin Zhao, Xihai Zhao, Xiaosheng Liu, Ye Cao, Daniel S Hippe, Jie Sun, Feiyu Li, Jianrong Xu, Chun Yuan
BACKGROUND AND PURPOSE: It remains unclear whether direct vessel wall imaging can identify carotid high-risk lesions in symptomatic subjects and whether carotid plaque characteristics are more effective indicators for cerebral infarct severity than stenosis. This study sought to determine the associations of carotid plaque characteristics by MR imaging with stenosis and acute cerebral infarct (ACI) sizes on diffusion weighted imaging (DWI). MATERIALS AND METHODS: One hundred and fourteen symptomatic patients underwent carotid and brain MRI...
September 2013: European Journal of Radiology
Biao Huang, Wan-Qun Yang, Xin-Tong Liu, Hong-Jun Liu, Pei-Jun Li, Hai-Ke Lu
PURPOSE: To investigate basilar artery atherosclerotic plaque distribution characteristics in symptomatic patients using 3.0T high-resolution MRI. MATERIALS AND METHODS: Thirty-eight patients with recent ischemic strokes or transient ischemic attacks were included. Conventional angiographic luminal imaging of these patients showed at least 30% basilar artery stenosis. Patients then underwent basilar artery high-resolution MRI examinations (T2WI, T1WI and post-contrast enhanced T1WI in short axial and long axial views)...
April 2013: European Journal of Radiology
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