Intravascular enhancement sign at 3D T1-weighted turbo spin echo sequence is associated with cerebral atherosclerotic stenosis

• Published in: Magnetic resonance imaging Vol. 115; p. 110270
• Main Authors: Wang, Bo, Ouyang, Feng, Wu, Qin, Chen, Jingting, Liu, Jie, Xu, Zihe, Lv, Lianjiang, Yu, Nianzu, Zeng, Xianjun
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.01.2025
• Subjects: Aged; Constriction, Pathologic - diagnostic imaging; Female; High resolution-vessel wall imaging; Humans; Imaging, Three-Dimensional - methods; Intracranial Arteriosclerosis - complications; Intracranial Arteriosclerosis - diagnostic imaging; Intracranial atherosclerotic stenosis; Intravascular enhancement sign; Magnetic Resonance Angiography - methods; Magnetic Resonance Imaging - methods; Male; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Retrospective Studies; Stroke; Intravascular enhancement sign; High resolution-vessel wall imaging; Stroke; Intracranial atherosclerotic stenosis
• ISSN: 0730-725X; 1873-5894; 1873-5894
• DOI: 10.1016/j.mri.2024.110270

Intravascular enhancement sign (IVES) at three-dimensional T1-weighted turbo spin echo (3D T1W TSE) sequence may be a simple hemodynamic maker. This study aims to investigate the association between IVES and features of intracranial atherosclerotic stenosis (ICAS). Retrospective analysis of clinical and imaging data of patients who underwent high resolution-vessel wall imaging (HR-VWI) examination from May 2021 to May 2023. The number of IVES vessels and ICAS features at HR-VWI were extracted by two neuroradiologists. Paired comparisons and correlation analysis on these indicators were performed. A total of 118 patients with ICAS in the first segment of the middle cerebral artery and accompanied by unilateral IVES were enrolled. Compared to the non-IVES side, a higher incidence of ischemic events and intraplaque hemorrhage (IPH), higher degree of vascular stenosis and enhancement, lower remodeling index, and lower signal intensity ratio (SIR) were found in subjects with IVES. In the ICAS with IVES, 79.66 % showed severe stenosis and occlusion; in the ICAS with severe stenosis and occlusion, 89.5 % showed IVES in the distal. A multivariable logistic regression model identified the vascular stenosis degree (OR = 1.922; 95 %CI [1.37–2.692]; P < 0.001), enhanced-degree (OR = 2.486; 95 %CI [1.315–4.698]; P = 0.005), position (OR = 2.869; 95 %CI [1.255–6.560]; P = 0.012), and SIR (OR = 0.032; 95 %CI [0.004–0.275]; P = 0.002) were independent association with the presence of IVES. The area under the curve was 0.911 for the use of IVES vessel quantities to identify severe stenosis and occlusion of arterial lumen. The number of IVES vessels was associated with the local features of ICAS, which may indicate severe stenosis and occlusion in the major branches of the proximal artery. •The number of IVES vessels may characterize the risk of ICAS lesions.•The appearance of IVES indicates severe stenosis and occlusion of the proximal artery.•Combining IVES vessels and the ICAS features have good diagnostic value for stroke events.