Subacute vessel wall imaging at 7-T MRI in post-thrombectomy stroke patients

• Published in: Neuroradiology Vol. 61; no. 10; pp. 1145 - 1153
• Main Authors: Truong, My, Markenroth Bloch, Karin, Andersen, Mads, Andsberg, Gunnar, Töger, Johannes, Wassélius, Johan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019; Springer Nature B.V
• Subjects: Acute Disease; Aged; Aged, 80 and over; Blood vessels; Carotid artery; Carotid Artery, Internal - diagnostic imaging; Carotid Artery, Internal - surgery; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - surgery; Cerebral Angiography - methods; Cerebral blood flow; Clinical Medicine; Diagnostic Neuroradiology; Diagnostic systems; Engineering and Technology; Female; High resolution; Humans; Image Enhancement; Image quality; Image resolution; Imaging; Imaging, Three-Dimensional - methods; Implants; Infarction, Middle Cerebral Artery - diagnostic imaging; Infarction, Middle Cerebral Artery - surgery; Intracranial Arteriosclerosis - diagnostic imaging; Intracranial Arteriosclerosis - surgery; Ischemia; Klinisk medicin; Lesions; Magnetic Resonance Angiography; Magnetic resonance imaging; Male; Medical and Health Sciences; Medical Engineering; Medical Image Processing; Medical Imaging; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Medicinsk bildbehandling; Medicinsk bildvetenskap; Medicinteknik; Middle Aged; Neurologi; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Occlusion; Perfusion Imaging - methods; Postoperative Complications - diagnostic imaging; Radiologi och bildbehandling; Radiology; Radiology and Medical Imaging; Radiology, Nuclear Medicine and Medical Imaging; Restoration; Stents; Stroke; Stroke - diagnostic imaging; Stroke - surgery; Surgical implants; Teknik; Thrombectomy; Vessel wall imaging; 7-T MRI; Thrombectomy; Stent retriever; Embolic stroke
• ISSN: 0028-3940; 1432-1920; 1432-1920
• DOI: 10.1007/s00234-019-02242-9

Purpose Reports from 3-T vessel wall MRI imaging have shown contrast enhancement following thrombectomy for acute stroke, suggesting potential intimal damage. Comparisons have shown higher SNR and more lesions detected by vessel wall imaging when using 7 T compared with 3 T. The aim of this study was to investigate the vessel walls after stent retriever thrombectomy using high-resolution vessel wall imaging at 7 T. Methods Seven patients with acute stroke caused by occlusion of the distal internal carotid artery (T-occlusion), or proximal medial cerebral artery, and treated by stent retriever thrombectomy with complete recanalization were included and examined by 7-T MRI within 2 days. The MRI protocol included a high-resolution black blood sequence with prospective motion correction (iMOCO), acquired before and after contrast injection. Flow measurements were performed in the treated and untreated M1 segments. Results All subjects completed the MRI examination. Image quality was independently rated as excellent by two neuroradiologists for all cases, and the level of motion artifacts did not impair diagnostic quality, despite severe motion in some cases. Contrast enhancement correlated with the deployment location of the stent retrievers. Flow data showed complete restoration of flow after treatment. Conclusion Vessel wall imaging with prospective motion correction can be performed in patients following thrombectomy with excellent imaging quality at 7 T. We show that vessel wall contrast enhancement is the normal post-operative state and corresponds to the deployment location of the stent retriever.