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. Atherosclerotic plaques were classified as asymptomatic or symptomatic. Two blinded neuroradiologists independently ranked each lesion for the presence of intraplaque enhancement by use of a 5-point scale (1-5). Furthermore, plaque enhancement was quantified as the relative change in T1WI spin-echo signal intensity (postcontrast/precontrast) in the vessel wall at the site of each intracranial atherosclerotic disease lesion. RESULTS: Intraplaque enhancement was observed in 7 of 10 (70%) symptomatic plaques, in contrast to 1 of 12 (8%) asymptomatic plaques. Interobserver reliability correlated well for intraplaque enhancement (κ = 0.82). The degree of relative plaque enhancement in symptomatic versus asymptomatic lesions (63% versus 23%) was statistically significant (P = .001, t test). CONCLUSIONS: In this pilot study, we determined that intraplaque enhancement could be reliably evaluated with the use of cross-sectional imaging and analysis of vessels/plaques by use of conventional neuroanatomic MR imaging protocols. In addition, we observed a strong association between intraplaque enhancement in severe intracranial atherosclerotic disease lesions and ischemic events with the use of conventional MR imaging. Our preliminary study suggests that T1 gadolinium-enhancing plaques may be an indicator of progressing or symptomatic intracranial atherosclerotic disease.
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. Atherosclerotic plaques were classified as asymptomatic or symptomatic. Two blinded neuroradiologists independently ranked each lesion for the presence of intraplaque enhancement by use of a 5-point scale (1-5). Furthermore, plaque enhancement was quantified as the relative change in T1WI spin-echo signal intensity (postcontrast/precontrast) in the vessel wall at the site of each intracranial atherosclerotic disease lesion. RESULTS: Intraplaque enhancement was observed in 7 of 10 (70%) symptomatic plaques, in contrast to 1 of 12 (8%) asymptomatic plaques. Interobserver reliability correlated well for intraplaque enhancement (κ = 0.82). The degree of relative plaque enhancement in symptomatic versus asymptomatic lesions (63% versus 23%) was statistically significant (P = .001, t test). CONCLUSIONS: In this pilot study, we determined that intraplaque enhancement could be reliably evaluated with the use of cross-sectional imaging and analysis of vessels/plaques by use of conventional neuroanatomic MR imaging protocols. In addition, we observed a strong association between intraplaque enhancement in severe intracranial atherosclerotic disease lesions and ischemic events with the use of conventional MR imaging. Our preliminary study suggests that T1 gadolinium-enhancing plaques may be an indicator of progressing or symptomatic intracranial atherosclerotic disease.
Authors: Li Dong; Williams S Kerwin; Huijun Chen; Baocheng Chu; Hunter R Underhill; Moni Blazej Neradilek; Thomas S Hatsukami; Chun Yuan; Xue-Qiao Zhao Journal: Radiology Date: 2011-04-14 Impact factor: 11.105
Authors: William S Kerwin; Kevin D O'Brien; Marina S Ferguson; Nayak Polissar; Thomas S Hatsukami; Chun Yuan Journal: Radiology Date: 2006-09-11 Impact factor: 11.105
Authors: William Kerwin; Andrew Hooker; Mary Spilker; Paolo Vicini; Marina Ferguson; Thomas Hatsukami; Chun Yuan Journal: Circulation Date: 2003-02-18 Impact factor: 29.690
Authors: R H Swartz; S S Bhuta; R I Farb; R Agid; R A Willinsky; K G Terbrugge; J Butany; B A Wasserman; D M Johnstone; F L Silver; D J Mikulis Journal: Neurology Date: 2009-02-17 Impact factor: 9.910
Authors: Matthew D Alexander; Adam de Havenon; Seong-Eun Kim; Dennis L Parker; Joseph S McNally Journal: Neuroradiology Date: 2019-01-24 Impact factor: 2.804
Authors: Adam de Havenon; Mahmud Mossa-Basha; Lubdha Shah; Seong-Eun Kim; Min Park; Dennis Parker; J Scott McNally Journal: Neuroradiology Date: 2017-09-23 Impact factor: 2.804
Authors: Ju-Yu Chueh; Kajo van der Marel; Matthew J Gounis; Todd LeMatty; Truman R Brown; Sameer A Ansari; Timothy J Carroll; Amanda K Buck; Xiaohong Joe Zhou; A Rano Chatterjee; Robert M King; Hui Mao; Shaokuan Zheng; Olivia W Brooks; Jeff W Rappleye; Richard H Swartz; Edward Feldmann; Tanya N Turan Journal: J Neurointerv Surg Date: 2017-03-09 Impact factor: 5.836
Authors: K D Vo; A J Yoo; A Gupta; Y Qiao; A S Vagal; J A Hirsch; D M Yousem; C Lum Journal: AJNR Am J Neuroradiol Date: 2015-10-01 Impact factor: 3.825
Authors: A S Al-Smadi; R N Abdalla; A H Elmokadem; A Shaibani; M C Hurley; M B Potts; B S Jahromi; T J Carroll; S A Ansari Journal: AJNR Am J Neuroradiol Date: 2019-05-09 Impact factor: 3.825
Authors: Jae W Song; Brianna F Moon; Morgan P Burke; Srikant Kamesh Iyer; Mark A Elliott; Haochang Shou; Steven R Messé; Scott E Kasner; Laurie A Loevner; Mitchell D Schnall; John E Kirsch; Walter R Witschey; Zhaoyang Fan Journal: J Neuroimaging Date: 2020-05-11 Impact factor: 2.486