T1 Gadolinium Enhancement of Intracranial Atherosclerotic Plaques Associated with Symptomatic Ischemic Presentations
T1 Gadolinium Enhancement of Intracranial Atherosclerotic Plaques Associated with Symptomatic Ischemic Presentations
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DOI：
10.3174/ajnr.a3606
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发表时间：
2013-12-01
影响因子：
3.5
通讯作者：
Ansari, S. A.
中科院分区：
文献类型：
--
作者：
Vakil, P.;Vranic, J.;Ansari, S. A.
背景和目的：近年来，高场强和高分辨率MR成像研究了颅内动脉粥样硬化斑块的对比增强作为缺血性卒中发生的危险因素。我们研究了在1.5T的常规MR成像的可靠性，在评估斑块内增强和急性脑血管缺血性表现的关系，在患者严重的颅内动脉粥样硬化diseases.MATERIALS和METHODS：我们回顾性地确定和分析了19例22高级别颅内动脉粥样硬化性疾病斑块（>70%狭窄）的血管横截面可视化的神经解剖MR成像。动脉粥样硬化斑块分为无症状或有症状。两名设盲的神经放射科医生使用5分制（1-5）对每个病变是否存在斑块内增强进行独立评级。此外，斑块增强被量化为在T1 WI自旋回波信号强度的相对变化（对比后/对比前）在血管壁的网站上的每个颅内动脉粥样硬化疾病lose.Results：斑块内增强观察到7 10（70%）有症状的斑块，相比之下，1 12（8%）无症状的斑块。斑块内增强的观察者间可靠性相关性良好（kappa = 0.82）。有症状与无症状病变的相对斑块增强程度（63%与23%）具有统计学显著性（P = 0.001，t检验）。结论：在这项初步研究中，我们确定斑块内增强可以通过使用常规神经解剖MR成像协议的横截面成像和血管/斑块分析进行可靠评估。此外，我们观察到严重颅内动脉粥样硬化病变斑块内增强与使用常规MR成像的缺血性事件之间存在强相关性。我们的初步研究表明，T1钆增强斑块可能是进展性或症状性颅内动脉粥样硬化疾病的指标。
BACKGROUND AND PURPOSE: Contrast enhancement of intracranial atherosclerotic plaques has recently been investigated using high field and high resolution MR imaging as a risk factor in the development of ischemic stroke. We studied the reliability of conventional MR imaging at 1.5T in evaluating intraplaque enhancement and its relationship with acute cerebrovascular ischemic presentations in patients with severe intracranial atherosclerotic disease.MATERIALS AND METHODS: We retrospectively identified and analyzed 19 patients with 22 high-grade intracranial atherosclerotic disease plaques (>70% stenosis) in vessels cross-sectionally visualized by neuroanatomic MR imaging. Atherosclerotic plaques were classified as asymptomatic or symptomatic. Two blinded neuroradiologists independently ranked each lesion for the presence of intraplaque enhancement by use of a 5-point scale (1-5). Furthermore, plaque enhancement was quantified as the relative change in T1WI spin-echo signal intensity (postcontrast/precontrast) in the vessel wall at the site of each intracranial atherosclerotic disease lesion.RESULTS: Intraplaque enhancement was observed in 7 of 10 (70%) symptomatic plaques, in contrast to 1 of 12 (8%) asymptomatic plaques. Interobserver reliability correlated well for intraplaque enhancement (kappa = 0.82). The degree of relative plaque enhancement in symptomatic versus asymptomatic lesions (63% versus 23%) was statistically significant (P = .001, t test).CONCLUSIONS: In this pilot study, we determined that intraplaque enhancement could be reliably evaluated with the use of cross-sectional imaging and analysis of vessels/plaques by use of conventional neuroanatomic MR imaging protocols. In addition, we observed a strong association between intraplaque enhancement in severe intracranial atherosclerotic disease lesions and ischemic events with the use of conventional MR imaging. Our preliminary study suggests that T1 gadolinium-enhancing plaques may be an indicator of progressing or symptomatic intracranial atherosclerotic disease.