Ka Eun Lee MD, Presenter: Nothing to Disclose

Chang-Woo Ryu MD, Abstract Co-Author: Nothing to Disclose

Sun Mi Kim MD, Abstract Co-Author: Nothing to Disclose

Eui Jong Kim, Abstract Co-Author: Nothing to Disclose

Geon-Ho Jahng PhD, Abstract Co-Author: Nothing to Disclose

Woo Suk Choi, Abstract Co-Author: Nothing to Disclose

The early detection of vulnerable plaque can prevent acute infarct. Although the wall enhancement is related to the development of the plaque, there were no studies to investigate the relationship between the vulnerability of plaque and vessel wall enhancement. Therefore, we studied the correlation of vessel wall enhancement and acute cerebral infarction.

Patients with acute cerebral infarction underwent brain MRI, MR angiography (MRA), and pre- and post-contrast-enhanced (CE) T1-weighted FLAIR (T1W-FLAIR, TR=2100ms, TE=14ms, slice thickness 2mm) with pre-saturation of inflowing blood to obtain black blood images. More than 50% stenosis of ipsilateral ICA, risk of cardiogenic embolization, and large territorial infarction with proximal MCA occlusion were excluded. Clinical information factors of hypertension, diabetes mellitus, age, and sex were reviewed. Ipsilateral MCA wall enhancement evaluated with CE T1W-FLAIR and ipsilateral MCA stenosis evaluated with MRA. We subdivided total patients into infarction in unilateral MCA territory (n=50) and infarction in posterior circulation(n=26).

Seventy-six patients(mean age 66.9 years, 40 male, 36 female) with focal cerebral infarction included. CE T1W-FLAIR detected wall enhancement in 36 patients and MRA showed MCA stenosis in 13 patients. Fisher’s exact test showed statistically significant relationship between wall enhancement and MCA stenosis (p<0.001). The multiple regression test showed that there were no relationship between wall enhancement and clinical factors, except age (p<0.005). On comparison of two groups, the difference of wall enhancement was not statistically significant (p=0.61, 24/50 and 12/26) and there was no correlation for clinical factors.

The MCA wall enhancement showed no correlation with infarction. Therefore, wall enhancement is an insufficient tool for prediction of vascular vulnerability. Although wall enhancement is noted in most MCA stenosis, wall enhancement without stenosis is probably resulted from positive remodeling of the vessel. Also, the age had significant relationship with the neovascularization of intracranial arterial wall.

This study was designed to find the parameter to predict the vulnerability of plaque and establish the relationship of vessel wall enhancement and infarction.

Lee, K, Ryu, C, Kim, S, Kim, E, Jahng, G, Choi, W, Relationship of Plaque Vulnerability to the Wall Enhancement of Intracranial Artery.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034479.html