Objective: To discuss the feasibility and clinical value of high-resolution magnetic resonance vessel wall imaging (HRMR VWI) for intracranial arterial stenosis. Date Sources: We retrieved information from PubMed ...Objective: To discuss the feasibility and clinical value of high-resolution magnetic resonance vessel wall imaging (HRMR VWI) for intracranial arterial stenosis. Date Sources: We retrieved information from PubMed database up to December 2015, using various search terms including vessel wall imaging (VWI), high-resolution magnetic resonance imaging, intracranial arterial stenosis, black blood, and intracranial atherosclerosis. Study Selection: We reviewed peer-reviewed articles printed in English on imaging technique of VWI and characteristic findings of various intracranial vasculopathies on VWI. We organized this data to explain the value of VWI in clinical application. Results: VWI with black blood technique could provide high-quality images with submillimeter voxel size, and display both the vessel wall and lumen of intracranial artery simultaneously. Various intracranial vasculopathies (atherosclerotic or nonatherosclerotic) had differentiating features including pattern of wall thickening, enhancement, and vessel remodeling on VWI. This technique could be used for determining causes of stenosis, identification of stroke mechanism, risk-stratifying patients, and directing therapeutic management in clinical practice. In addition, a new morphological classification based on VWI could be established for predicting the efficacy of endovascular therapy. Conclusions: This review highlights the value of HRMR VWI for discrimination of different intracranial vasculopathies and directing therapeutic management.展开更多
Background: There are few studies for evaluating plaque characteristics of nonstenotic basilar arteries (BA). Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo...Background: There are few studies for evaluating plaque characteristics of nonstenotic basilar arteries (BA). Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo acquisition (VISTA) and investigate the differences between the patients with and without isolated pontine infarction (IPI). Methods: Twenty-four consecutive symptomatic patients with nonstenotic BA on time of flight magnetic resonance angiography (TOF MRA) were enrolled from China-Japan Friendship Hospital between January 2014 and December 2014. BA was classified as "normal" or "irregular" based on TOF MRA, and "normal wall", "slight wall-thickening", and "plaque" based on three-dimensional VISTA images. Outcomes from MRA and VISTA were compared. Patients were categorized as IPI and non-lPl groups based on the diffusion-weighted imaging. Clinical and plaque characteristics were compared between the two groups. Results: A total of 1024 image slices including 311 (30.37%) plaque slices, 427 (41.70%) slight wall-thickening slices, and 286 (27.93%) normal wall slices for the entire BA from 23 patients were finally included for analysis. VISTA images detected plaques in all the 9 (100%) irregular MRA patients and 7 of 14 (50%) normal MRA patients. IPl was found in 11 (47.83%) patients. Compared to non-IPI group, the IPI group had a higher percentage of plaque slices (P = 0.001 ) and lower percentage of normal wall slices (P = 0.014) than non-IPl group. Conclusions: Three-dimensional V1STA images enable detection of BA plaques not visualized by MRA. BA plaques could be found in both the IPl and non-IPl group. However, IPI group showed plaques more extensively in BA than the non-IPI group.展开更多
Background:There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH).The aim of this study was to determine wall characteristics of VAH with three-dimensional volum...Background:There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH).The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.Methods:Thirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015.The patients were classified as "acquired atherosclerotic stenosis" or "VAH" based on 3D VISTA images.The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions,and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall).Wall characteristics of basilar arteries and vertebral arteries were also assessed.The clinical and wall characteristics were compared between the two groups.Results:Five of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images.25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall.In the 16 patients with atherosclerosis,plaque was found in 9 patients,slight wall thickening in 6 patients,and thrombus and wall thickening in 1 patient.Compared with VAH patients with normal wall,VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P =0.000).Conclusions:Three-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH.VAH was also prone to atherosclerotic processes.展开更多
文摘Objective: To discuss the feasibility and clinical value of high-resolution magnetic resonance vessel wall imaging (HRMR VWI) for intracranial arterial stenosis. Date Sources: We retrieved information from PubMed database up to December 2015, using various search terms including vessel wall imaging (VWI), high-resolution magnetic resonance imaging, intracranial arterial stenosis, black blood, and intracranial atherosclerosis. Study Selection: We reviewed peer-reviewed articles printed in English on imaging technique of VWI and characteristic findings of various intracranial vasculopathies on VWI. We organized this data to explain the value of VWI in clinical application. Results: VWI with black blood technique could provide high-quality images with submillimeter voxel size, and display both the vessel wall and lumen of intracranial artery simultaneously. Various intracranial vasculopathies (atherosclerotic or nonatherosclerotic) had differentiating features including pattern of wall thickening, enhancement, and vessel remodeling on VWI. This technique could be used for determining causes of stenosis, identification of stroke mechanism, risk-stratifying patients, and directing therapeutic management in clinical practice. In addition, a new morphological classification based on VWI could be established for predicting the efficacy of endovascular therapy. Conclusions: This review highlights the value of HRMR VWI for discrimination of different intracranial vasculopathies and directing therapeutic management.
基金This study was supported by grants from China- Japan Friendship Hospital Youth Science and Technology Excellence Project (No. 2014-QNYC-A-04), National Natural Science Foundation of China (No. 81173595, No. 30670731, No. 81070925 and No. 81471767), and National Basic Research Program (973 Program) of China (No. 2013CB733805).
文摘Background: There are few studies for evaluating plaque characteristics of nonstenotic basilar arteries (BA). Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo acquisition (VISTA) and investigate the differences between the patients with and without isolated pontine infarction (IPI). Methods: Twenty-four consecutive symptomatic patients with nonstenotic BA on time of flight magnetic resonance angiography (TOF MRA) were enrolled from China-Japan Friendship Hospital between January 2014 and December 2014. BA was classified as "normal" or "irregular" based on TOF MRA, and "normal wall", "slight wall-thickening", and "plaque" based on three-dimensional VISTA images. Outcomes from MRA and VISTA were compared. Patients were categorized as IPI and non-lPl groups based on the diffusion-weighted imaging. Clinical and plaque characteristics were compared between the two groups. Results: A total of 1024 image slices including 311 (30.37%) plaque slices, 427 (41.70%) slight wall-thickening slices, and 286 (27.93%) normal wall slices for the entire BA from 23 patients were finally included for analysis. VISTA images detected plaques in all the 9 (100%) irregular MRA patients and 7 of 14 (50%) normal MRA patients. IPl was found in 11 (47.83%) patients. Compared to non-IPI group, the IPI group had a higher percentage of plaque slices (P = 0.001 ) and lower percentage of normal wall slices (P = 0.014) than non-IPl group. Conclusions: Three-dimensional V1STA images enable detection of BA plaques not visualized by MRA. BA plaques could be found in both the IPl and non-IPl group. However, IPI group showed plaques more extensively in BA than the non-IPI group.
基金Source of Support: This study was supported by grants from China Postdoctoral Science Foundation (No. 2014M562633), China-Japan Friendship Hospital Youth Science and Technology Excellence Project (No. 2014-QNYC-A-04), National Natural Science Foundation of China (No. 81173595, 30670731, 81070925, and 81471767), and National Basic Research Program (973 Program) of China (No. 2013CB733805).
文摘Background:There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH).The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.Methods:Thirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015.The patients were classified as "acquired atherosclerotic stenosis" or "VAH" based on 3D VISTA images.The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions,and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall).Wall characteristics of basilar arteries and vertebral arteries were also assessed.The clinical and wall characteristics were compared between the two groups.Results:Five of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images.25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall.In the 16 patients with atherosclerosis,plaque was found in 9 patients,slight wall thickening in 6 patients,and thrombus and wall thickening in 1 patient.Compared with VAH patients with normal wall,VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P =0.000).Conclusions:Three-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH.VAH was also prone to atherosclerotic processes.