title: MRI characteristics of carotid bulb atypical fibromuscular dysplasia in black stroke patients.
abstract: OBJECTIVE
  In black stroke patients, a particular form of fibromuscular dysplasia (FMD), called atypical FMD (aFMD), is involved in stroke mechanism. The high rate of stroke recurrence under medical treatment leads to propose surgery in such patients. Regarding its location level on the carotid bulb, aFMD is often confused with atherosclerosis or free-floating thrombus. Nowadays, only histology can confirm the diagnosis. MRI of aFMD has never been assessed.
  
  
  METHODS
  The constitution of a black patient's cohort with aFMD-related ischemic stroke is currently in progress in the French West Indies, Martinique. In patients scheduled for surgery, MRI of the carotid bifurcation was analyzed preoperatively, with subsequent histological examination of the excised specimen. The first four black stroke patients with MRI and histological findings are described.
  
  
  RESULTS
  On imaging, aFMD lesion was homogeneous with isosignal on T2-weighted sequences and slight hypersignal on T1-weighted sequences with mild gadolinium enhancement of the inner layer. Histological findings confirmed the aFMD mainly located in the intima.
  
  
  CONCLUSIONS
  aFMD generates a particular MRI pattern in our four patients, which could increase the diagnosis accuracy. Carotid bulb lesion in black stroke patients should suggest aFMD and MRI analysis may contribute to rule out differential diagnoses.
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique. Electronic address: julien.joux@gmail.com.
authors.forename: Julien
authors.initials: J
authors.lastname: Joux
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mejdoubi
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Quere
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Colombani
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Hennequin
authors.affiliation: Department of anatomic and cellular pathology (L.D.), hôpital Bichat, Paris, France.
authors.forename: Lydia
authors.initials: L
authors.lastname: Deschamps
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique.
authors.forename: Séverine
authors.initials: S
authors.lastname: Jeannin
authors.affiliation: Departments of neurology (J.J., S.J., S.O.), radiology (M.M., J.-B.Q., S.C.), vascular surgery (J.-L.H.), Fort-de-France University Hospital, Fort-de-France, Martinique.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Olindo
mesh_terms: D000328:Adult; D044383:Black People; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005352:Fibromuscular Dysplasia / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Black; Fibromuscular dysplasia; Magnetic resonance imaging; Stroke