title: Intracranial atherosclerotic plaque enhancement in patients with ischemic stroke.
abstract: OBJECTIVE
  Inflammation of an atherosclerotic plaque is a well-known risk factor in the development of ischemic stroke and myocardial infarction. MR imaging is capable of characterizing inflammation by assessing plaque enhancement in both extracranial carotid arteries and coronary arteries. Our goal was to determine whether enhancing intracranial atherosclerotic plaque was present in the vessel supplying the territory of infarction by using high-resolution vessel wall MR imaging.
  
  
  METHODS
  High-resolution vessel wall 3T MR imaging studies performed in 29 patients with ischemic stroke and intracranial vascular stenoses were reviewed for presence and strength of plaque enhancement.
  
  
  RESULTS
  Sixteen patients were studied during the acute phase (<4 weeks from acute stroke), 5 patients in the subacute phase (4-12 weeks), and 8 patients in the chronic phase (>12 weeks) of the ischemic injury. In all of the acute phase patients, atherosclerotic plaque in the vessel supplying the stroke territory demonstrated strong enhancement. There was a trend of decreasing enhancement as the time of imaging relative to the ischemic event increased.
  
  
  CONCLUSIONS
  Strong pathologic enhancement of intracranial atherosclerotic plaque was seen in all patients imaged within 4 weeks of ischemic stroke in the vessel supplying the stroke territory. The strength and presence of enhancement of the atherosclerotic plaque decreased with increasing time after the ischemic event. These findings suggest a relationship between enhancing intracranial atherosclerotic plaque and acute ischemic stroke.
authors.affiliation: Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, M5T Canada.
authors.forename: M
authors.initials: M
authors.lastname: Skarpathiotakis
authors.forename: D M
authors.initials: DM
authors.lastname: Mandell
authors.forename: R H
authors.initials: RH
authors.lastname: Swartz
authors.forename: G
authors.initials: G
authors.lastname: Tomlinson
authors.forename: D J
authors.initials: DJ
authors.lastname: Mikulis
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D002537:Intracranial Arteriosclerosis / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D012189:Retrospective Studies; D020521:Stroke / Q000473:pathology*; D019467:Subacute Care