In vivo high-resolution MR imaging of symptomatic and asymptomatic middle cerebral artery atherosclerotic stenosis.
OBJECTIVE
Recently, the technique of high-resolution magnetic resonance imaging (HR-MRI) has been developed to depict intracranial artery wall. We aimed to compare the vessel wall properties between symptomatic and asymptomatic atherosclerotic middle cerebral arteries (MCA) using HR-MRI.


METHODS
We studied 26 patients with symptomatic and 35 patients with asymptomatic MCA stenosis. Routine cranial MRI, magnetic resonance angiography and HR-MRI were performed on each patient. The cross-sectional images of MCA wall on HR-MRI were compared between the two groups.


RESULTS
The degree of MCA stenosis was similar between the two groups (67.9% vs 63.9%, P=0.327). On HR-MRI, eccentric plaques were observed in 26 (100%) symptomatic and 28 (80%) asymptomatic stenosis. In the remaining seven (20%) asymptomatic stenosis, only constrictive remodeling (vessel shrinkage) was observed. Compared with the asymptomatic group, symptomatic MCA stenosis had a larger wall area (P<0.001), greater remodeling ratio (P<0.001), higher prevalence of expansive remodeling (outward expansion of the vessel wall) (P=0.003) and lower prevalence of constrictive remodeling (P=0.008).


CONCLUSIONS
Different vessel wall properties on HR-MRI were observed between symptomatic and asymptomatic MCA stenosis. Further prospective studies are required to investigate whether HR-MRI is a helpful tool in stratifying stroke risk in patients with MCA atherosclerotic disease.
Xu
Wei-Hai
WH
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Dongcheng Strict, Shuaifuyuan 1, Beijing 100730, China. xuwhpumch@yahoo.com.cn
Li
Ming-Li
ML
Gao
Shan
S
Ni
Jun
J
Zhou
Li-Xin
LX
Yao
Ming
M
Peng
Bin
B
Feng
Feng
F
Jin
Zheng-Yu
ZY
Cui
Li-Ying
LY
D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D002545:Brain Ischemia; D016893:Carotid Stenosis / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D012306:Risk