-Original-

Contrast-Enhanced High-Resolution MRI for Evaluating Time Course Changes in Middle Cerebral Artery Plaques

Arata Abe¹, Tetsuro Sekine², Yuki Sakamoto¹, Mina Harada-Abe¹, Ryo Takagi², Satoshi Suda¹, Kentaro Suzuki¹, Junya Aoki¹, Masami Yoneyama³ and Kazumi Kimura¹

¹Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
²Department of Radiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
³Philips Electronics Japan, Tokyo, Japan

Background and Purpose: It is clinically important to evaluate time course changes in symptomatic middle cerebral artery (MCA) stenotic plaques because of likely recurrence. The objective of this study is to determine whether contrast-enhanced high-resolution magnetic resonance imaging (MRI) is a feasible method for this purpose.
Methods: Contrast-enhanced, high-resolution, 3D turbo spin-echo images with low refocusing flip angle control (3D LOWRAT) applied to 7 patients with symptomatic MCA stenosis were evaluated at the initial (1 month after stroke onset) and follow-up (7 months after stroke onset) stages, and statistical variables, including plaque-to-thalamus signal intensity ratio, degree of stenosis, and stroke recurrence obtained at the 2 stages, were compared. Stenotic change at the initial stage was compared to that at the follow-up stage using MR angiography.
Results: In 4 of the 7 patients, the signal intensity ratio measured at the follow-up stage was lower than that measured at the initial stage and in 1 patient, the stenosis subsequently improved. We used a Chi-Square Test. In the other 3 patients, the signal intensity ratios did not differ between the 2 stages, and ischemic stroke occurred in 2 of these 3 patients.
Conclusion: Gadolinium contrast enhancement was found to be useful for effective evaluation of time course changes in the stability of symptomatic MCA stenotic plaques.

J Nippon Med Sch 2018; 85: 28-33

Keywords
ischemic stroke, intracranial stenosis, atherosclerosis, magnetic resonance imaging, middle cerebral artery

Correspondence to
Arata Abe, MD, Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
abe@nms.ac.jp

Received, May 9, 2016
Accepted, November 1, 2017