Nonstenotic Culprit Plaque: The Utility of High-Resolution Vessel Wall MRI of Intracranial Vessels after Ischemic Stroke.
Nonstenotic Culprit Plaque: The Utility of High-Resolution Vessel Wall MRI of Intracranial Vessels after Ischemic Stroke.
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DOI：
10.1155/2015/356582
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发表时间：
2015
影响因子：
--
通讯作者：
Mossa-Basha M
中科院分区：
文献类型：
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作者：
de Havenon A;Yuan C;Tirschwell D;Hatsukami T;Anzai Y;Becker K;Sultan-Qurraie A;Mossa-Basha M
在美国，颅内动脉粥样硬化性疾病 (ICAD) 占缺血性中风的 9-15%。尽管高度狭窄 ICAD 占大多数中风，但据认为非狭窄 ICAD (nICAD) 也可能导致中风，尽管在标准管腔成像模式中被遗漏了。我们描述了一名患有复发性血栓栓塞性卒中和 TIA 的 nICAD 患者，但常规卒中检查结果为阴性。因此，他们被转诊进行动脉血管壁高分辨率磁共振成像 (HR-MRI)，结果发现具有多个高风险特征的非狭窄斑块，将其确定为患者血栓栓塞事件的病因。诊断导致从抗凝治疗过渡到抗血小板治疗，之后患者的临床事件得到解决。 HR-MRI 是一种成像技术，有可能指导缺血性中风患者的医疗管理，特别是隐源性中风。
Intracranial atherosclerotic disease (ICAD) accounts for 9–15% of ischemic stroke in the United States. Although highly stenotic ICAD accounts for most of the strokes, it is assumed that nonstenotic ICAD (nICAD) can result in stroke, despite being missed on standard luminal imaging modalities. We describe a patient with nICAD who suffered recurrent thromboembolic stroke and TIA but had a negative conventional stroke workup. As a result, they were referred for high-resolution magnetic resonance imaging (HR-MRI) of the arterial vessel wall, which identified a nonstenotic plaque with multiple high-risk features, identifying it as the etiology of the patient's thromboembolic events. The diagnosis resulted in a transition from anticoagulation to antiplatelet therapy, after which the patient's clinical events resolved. HR-MRI is an imaging technique that has the potential to guide medical management for patients with ischemic stroke, particularly in cryptogenic stroke.