Non-stenotic intracranial arteries have atherosclerotic changes in acute ischemic stroke patients: a 3T MRI study

• Published in: Neuroradiology Vol. 57; no. 10; pp. 1007 - 1013
• Main Authors: Lee, Woo Jin, Choi, Hyun Seok, Jang, Jinhee, Sung, Jinkyeong, Kim, Tae-Won, Koo, Jaseong, Shin, Yong Sam, Jung, So-Lyung, Ahn, Kook-Jin, Kim, Bum-soo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2015; Springer Nature B.V
• Subjects: Atherosclerosis; Brain; Cerebral Arterial Diseases - complications; Cerebral Arterial Diseases - pathology; Cerebral Arteries - pathology; Diagnostic Neuroradiology; Female; Humans; Image Interpretation, Computer-Assisted - methods; Imaging; Intracranial Arteriosclerosis - complications; Intracranial Arteriosclerosis - pathology; Ischemia; Magnetic Resonance Angiography - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neuroradiology; Neurosciences; Neurosurgery; NMR; Nuclear magnetic resonance; Radiology; Reproducibility of Results; Sensitivity and Specificity; Stroke; Stroke - etiology; Stroke - pathology; Intracranial atherosclerosis; Ischemic stroke; Atherosclerosis; MR angiography
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-015-1566-9

Introduction The aim of this study is to evaluate the degree of atherosclerotic changes in intracranial arteries by assessing arterial wall thickness using T1-weighted 3D-turbo spin echo (3D-TSE) and time-of-flight MR angiography (TOF-MRA) in patients with acute ischemic stroke as compared with unaffected controls. Methods Thirty-three patients with acute ischemic stroke and 36 control patients were analyzed. Acute ischemic stroke patients were divided according to TOAST classification. At both distal internal carotid arteries and basilar artery without stenosis, TOF-MRA was used to select non-stenotic portion of assessed arteries. 3D-TSE was used to measure the area including the lumen and wall (Area Outer ) and luminal area (Area Inner ). The area of the vessel wall (Area VW ) of assessed intracranial arteries and the ratio index (RI) of each patient were determined. Results Area Inner , Area Outer , Area VW , and RI showed good inter-observer reliability and excellent intra-observer reliability. Area Inner did not significantly differ between stroke patients and controls ( P  = 0.619). However, Area Outer , Area VW , and RI were significantly larger in stroke patients ( P  < 0.001). The correlation coefficient between Area Inner and Area Outer was higher in the controls ( r  = 0.918) than in large vessel disease patients ( r  = 0.778). RI of large vessel disease patients was significantly higher than that of normal control, small vessel disease, and cardioembolic groups. Conclusion In patients with acute ischemic stroke, wall thickening and positive remodeling are evident in non-stenotic intracranial arteries. This change is more definite in stroke subtype that is related to atherosclerosis than that in other subtypes which are not.