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Distribution and natural course of intracranial vessel wall lesions in patients with ischemic stroke or TIA at 7.0 tesla MRI

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Previous studies using intracranial vessel wall MRI techniques showed that over 50 % of patients with ischemic stroke or TIA had one or more intracranial vessel wall lesions. In the current study, we assessed the preferential location of these lesions within the intracranial arterial tree and their potential changes over time in these patient groups.

Methods

Forty-nine patients with ischemic stroke (n = 25) or TIA (n = 24) of the anterior cerebral circulation underwent 7.0 T MRI, including a T1-weighted magnetization-preparation inversion recovery turbo-spin-echo (MPIR-TSE) sequence within one week and approximately one month after symptom onset. Intracranial vessel wall lesions were scored for multiple locations within the arterial tree and differences between one-week and one-month images.

Results

At baseline, 132 intracranial vessel wall lesions were found in 41 patients (84 %), located primarily in the anterior cerebral circulation (74 %), with a preferential location in the distal internal carotid artery and M1 and M2 segments of the middle cerebral artery. During follow-up, presence or enhancement patterns changed in 14 lesions (17 %).

Conclusions

A large burden of intracranial vessel wall lesions was found in both the anterior and posterior cerebral circulation. Most lesions were found to be relatively stable, possibly indicating a more generalized atherosclerotic process.

Key points

• Intracranial vessel wall lesions are present in patients with varying cerebrovascular diseases.

• Intracranial vessel wall 7.0 T MRI provides information on preferential location and natural course.

• Distal ICA and M1 and M2 segments of MCA are predilection sites.

• 83 % of lesions found remained stable, possibly indicating more generalized atherosclerosis.

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Abbreviations

A1:

A1 segment of anterior cerebral artery

ACA:

Anterior cerebral artery

FFE:

Fast field echo

FOV:

Field of view

ICA:

Internal carotid artery

IVI:

Intracranial vessel wall imaging

TIA:

Transient ischemic attack

M1:

M1 segment of middle cerebral artery

M2:

M2 segment of middle cerebral artery

M3:

M3 segment of middle cerebral artery

MCA:

Middle cerebral artery

MPIR-TSE:

Magnetization-preparation inversion recovery turbo-spin-echo

MRI:

Magnetic resonance imaging

NSA:

Number of signal averages

P1:

P1 segment of posterior cerebral artery

P2:

P2 segment of posterior cerebral artery

PCA:

Posterior cerebral artery

SSS-TOAST:

Stop Stroke Study Trial of Org 10172 in Acute Stroke Treatment

T:

Tesla

TE:

Echo time

TI:

Inversion time

TOF-MRA:

Time-of-flight magnetic resonance angiography

TR:

Repetition time

TSE:

Turbo-spin-echo

References

  1. Gorelick PB, Wong KS, Bae HJ, Pandey DK (2008) Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke 39:2396–2399

    Article  PubMed  Google Scholar 

  2. Qureshi AI, Caplan LR (2014) Intracranial atherosclerosis. Lancet 383:984–998

    Article  PubMed  Google Scholar 

  3. Park JK, Kim SH, Kim BS, Choi G, Jeong SY, Choi JC (2011) Imaging of intracranial plaques with black-blood double inversion recovery MR imaging and CT. J Neuroimaging 21:e64–e68

    Article  PubMed  Google Scholar 

  4. van der Kolk AG, Zwanenburg JJ, Brundel M et al (2011) Intracranial vessel wall imaging at 7.0-T MRI. Stroke 42:2478–2484

    Article  PubMed  Google Scholar 

  5. Turan TN, Bonilha L, Morgan PS, Adams RJ, Chimowitz MI (2011) Intraplaque hemorrhage in symptomatic intracranial atherosclerotic disease. J Neuroimaging 21:e159–e161

    Article  PubMed  Google Scholar 

  6. Xu WH, Li ML, Gao S et al (2011) Plaque distribution of stenotic middle cerebral artery and its clinical relevance. Stroke 42:2957–2959

    Article  PubMed  Google Scholar 

  7. Chung GH, Kwak HS, Hwang SB, Jin GY (2012) High resolution MR imaging in patients with symptomatic middle cerebral artery stenosis. Eur J Radiol 81:4069–4074

    Article  PubMed  Google Scholar 

  8. Kim YS, Lim SH, Oh KW et al (2012) The advantage of high-resolution MRI in evaluating basilar plaques: a comparison study with MRA. Atherosclerosis 224:411–416

    Article  CAS  PubMed  Google Scholar 

  9. Lou X, Ma N, Ma L, Jiang WJ (2013) Contrast-enhanced 3 T high-resolution MR imaging in symptomatic atherosclerotic basilar artery stenosis. AJNR Am J Neuroradiol 34:513–517

    Article  CAS  PubMed  Google Scholar 

  10. Skarpathiotakis M, Mandell DM, Swartz RH, Tomlinson G, Mikulis DJ (2013) Intracranial atherosclerotic plaque enhancement in patients with ischemic stroke. AJNR Am J Neuroradiol 34:299–304

    Article  CAS  PubMed  Google Scholar 

  11. van der Kolk AG, Hendrikse J, Brundel M et al (2013) Multi-sequence whole-brain intracranial vessel wall imaging at 7.0 tesla. Eur Radiol 23:2996–3004

    Article  PubMed  Google Scholar 

  12. Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ (1987) Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med 316:1371–1375

    Article  CAS  PubMed  Google Scholar 

  13. Kiechl S, Willeit J (1999) The natural course of atherosclerosis. Part II: vascular remodeling. Bruneck Study Group. Arterioscler Thromb Vasc Biol 19:1491–1498

    Article  CAS  PubMed  Google Scholar 

  14. Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw JJ, Amarenco P (2008) Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke. Stroke 39:1142–1147

    Article  PubMed  Google Scholar 

  15. Vink A, Schoneveld AH, Poppen M, de Kleijn DP, Borst C, Pasterkamp G (2002) Morphometric and immunohistochemical characterization of the intimal layer throughout the arterial system of elderly humans. J Anat 200:97–103

    Article  PubMed Central  PubMed  Google Scholar 

  16. Maes F, Collignon A, Vandermeulen D, Marchal G, Suetens P (1997) Multimodality image registration by maximization of mutual information. IEEE Trans Med Imaging 16:187–198

    Article  CAS  PubMed  Google Scholar 

  17. Chimowitz MI, Kokkinos J, Strong J et al (1995) The warfarin-aspirin symptomatic intracranial disease study. Neurology 45:1488–1493

    Article  CAS  PubMed  Google Scholar 

  18. Mazighi M, Tanasescu R, Ducrocq X et al (2006) Prospective study of symptomatic atherothrombotic intracranial stenoses: the GESICA study. Neurology 66:1187–1191

    Article  CAS  PubMed  Google Scholar 

  19. Turan TN, Makki AA, Tsappidi S et al (2010) Risk factors associated with severity and location of intracranial arterial stenosis. Stroke 41:1636–1640

    Article  PubMed Central  PubMed  Google Scholar 

  20. Pu Y, Liu L, Wang Y et al (2013) Geographic and sex difference in the distribution of intracranial atherosclerosis in china. Stroke 44:2109–2114

    Article  PubMed  Google Scholar 

  21. Cecchi E, Giglioli C, Valente S et al (2011) Role of hemodynamic shear stress in cardiovascular disease. Atherosclerosis 214:249–256

    Article  CAS  PubMed  Google Scholar 

  22. Tao WD, Liu M, Fisher M et al (2012) Posterior versus anterior circulation infarction: how different are the neurological deficits? Stroke 43:2060–2065

    Article  PubMed  Google Scholar 

  23. Adams HP Jr, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24:35–41

    Article  PubMed  Google Scholar 

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Acknowledgments

The scientific guarantor of this publication is Jeroen Hendrikse. The authors of this manuscript declare relationships with the following companies: Fredy Visser is employed by of Philips Healthcare, Best, the Netherlands. This study was performed within the framework of the Center for Translational Molecular Medicine (CTMM, www.ctmm.nl) project PARISk (grant 01C-202), and supported by the Dutch Heart Foundation. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in Stroke 2011;42(9):2478–2484 (in this technical study evaluating the small-coverage MPIR-TSE sequence, partial baseline data of 21 patients was published). Methodology: prospective, observational study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands

    Anja G. van der Kolk, Jaco J. M. Zwanenburg, Fredy Visser, Peter R. Luijten & Jeroen Hendrikse

  2. Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands

    Jaco J. M. Zwanenburg

  3. Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands

    Manon Brundel & Geert Jan Biessels

  4. Philips Healthcare, Best, The Netherlands

    Fredy Visser

Authors
  1. Anja G. van der Kolk
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  2. Jaco J. M. Zwanenburg
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  3. Manon Brundel
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  4. Geert Jan Biessels
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  5. Fredy Visser
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  6. Peter R. Luijten
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  7. Jeroen Hendrikse
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Corresponding author

Correspondence to Anja G. van der Kolk.

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van der Kolk, A.G., Zwanenburg, J.J.M., Brundel, M. et al. Distribution and natural course of intracranial vessel wall lesions in patients with ischemic stroke or TIA at 7.0 tesla MRI. Eur Radiol 25, 1692–1700 (2015). https://doi.org/10.1007/s00330-014-3564-4

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  • DOI: https://doi.org/10.1007/s00330-014-3564-4

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