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Research ArticleBrain

Gadolinium Enhancement of Atherosclerotic Plaque in the Middle Cerebral Artery: Relation to Symptoms and Degree of Stenosis

C.-W. Ryu, G.-H. Jahng and H.S. Shin
American Journal of Neuroradiology December 2014, 35 (12) 2306-2310; DOI: https://doi.org/10.3174/ajnr.A4038
C.-W. Ryu
aFrom the Departments of Radiology (C.-W.R., G.-H.J.)
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G.-H. Jahng
aFrom the Departments of Radiology (C.-W.R., G.-H.J.)
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H.S. Shin
bNeurosurgery (H.S.S.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
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Abstract

BACKGROUND AND PURPOSE: High-resolution MR imaging can depict intracranial arterial atherosclerotic plaques. Our aim was to evaluate the relationship between the degree of enhancement of MCA plaques on contrast-enhanced high-resolution MR imaging and ischemic stroke and stenosis severity.

MATERIALS AND METHODS: This study enrolled 36 patients diagnosed with moderate-to-severe atherosclerotic MCA stenosis. A contrast-enhanced T1-weighted volume isotropic turbo spin-echo acquisition sequence was acquired for assessing plaque enhancement. Plaque-to-CSF contrast ratio was calculated after the signal intensity of plaques at the stenotic segment was measured. Univariate comparison and multivariate logistic regression analyses were performed for symptomatic and asymptomatic groups to assess the relationship between symptomatic stenosis and independent variables, including plaque-to-CSF contrast ratio, degree of stenosis, and clinical risk factors. Plaque-to-CSF contrast ratio was compared between the moderate and severe stenosis groups.

RESULTS: Twenty-one patients had symptomatic MCA stenosis, and 15 had asymptomatic stenosis. The plaque-to-CSF contrast ratio was significantly higher in the symptomatic group than in the asymptomatic group (63.6 ± 10.6% versus 54.1 ± 13.5%, respectively; P < .05). The degree of stenosis also differed significantly between the 2 groups (P < .05). Multivariate analysis revealed that the degree of stenosis was the only independent predictor of ischemic stroke symptoms. The plaque-to-CSF contrast ratio of severe stenosis was significantly higher than that of moderate stenosis (66.8 ± 8.7% versus 55.9 ± 12.8%, respectively; P < .05).

CONCLUSIONS: Plaque enhancement was significantly higher in patients with symptomatic plaques and may have been affected by the degree of stenosis. A difference in plaque enhancement according to the degree of stenosis has implications for understanding the development of intracranial atherosclerotic plaques.

ABBREVIATIONS:

CR
plaque-to-CSF contrast ratio
Gd
gadolinium
HR-MRI
high-resolution MR imaging
ICAD
intracranial atherosclerotic disease
SI
signal intensity
WASID
Warfarin Aspirin Symptomatic Intracranial Disease
  • © 2014 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 35 (12)
American Journal of Neuroradiology
Vol. 35, Issue 12
1 Dec 2014
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Cite this article
C.-W. Ryu, G.-H. Jahng, H.S. Shin
Gadolinium Enhancement of Atherosclerotic Plaque in the Middle Cerebral Artery: Relation to Symptoms and Degree of Stenosis
American Journal of Neuroradiology Dec 2014, 35 (12) 2306-2310; DOI: 10.3174/ajnr.A4038

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Gadolinium Enhancement of Atherosclerotic Plaque in the Middle Cerebral Artery: Relation to Symptoms and Degree of Stenosis
C.-W. Ryu, G.-H. Jahng, H.S. Shin
American Journal of Neuroradiology Dec 2014, 35 (12) 2306-2310; DOI: 10.3174/ajnr.A4038
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