Guiding endovascular treatment of symptomatic atherosclerotic stenosis of middle cerebral artery with high-resolution magnetic resonance imaging / 国际脑血管病杂志

ABSTRACT

Objective To investigate the application value of high-resolution magnetic resonance imaging (HR-MRI) as an auxiliary means to evaluate the atherosclerotic stenosis of middle cerebral artery (MCA) before endovascular intervention.Methods Patients with the new infarction or transient ischemic attack in the MCA territories were examined with HR-MRI and digital subtraction angiography (DSA).HR-MRI was used to study the characteristics of atherosclerotic plaques of MCA,qualitatively analyze vascular stenosis rate and plaque load,and qualitatively analyze the plaque location,enhancement degree,and remodeling pattern.The results of HR-MRI examination were used to guide the selection of treatment methods,and the perioperative complications and 3-month outcome of patients treated with intravascular interventional therapy were statistically analyzed.Correlation analysis and consistent evaluation of MCA stenosis rate and stenosis degree measured by DSA and HR-MRI were conducted.Results Atherosclerotic plaques and luminal stenosis in the MCA were found in 25 patients.Among them,13 (52.0％) had positive remodeling,10 (40.0％) had negative remodeling,and 8 (32.0％) had plaques on the sides of perforator arteries.Of the 17 patients who underwent enhanced scan,11 (64.7％) had mild enhancement and 6 (36.3％) had obvious enhancement.Six patients (24％) were treated with endovascular treatment without perioperative complications.Five patients had good outcome and 1 had poor outcome.The stenosis rates of MCA measured by DSA and HR-MRI were 68.05％ ± 21.65％ and 70.9％ ± 20.7％,respectively (t =1.673,P=0.107).The two methods had good correlation (r=0.917,P＜ 0.001).In addition,in the diagnosis of mild (P =0.500),moderate (P =0.063) and severe (P =0.250) stenoses,DSA and HR-MRI also had good consistency.Conclusion HR-MRI can clearly show the characteristics of the middle cerebral artery lumen and plaque.As a preoperative evaluation means for assisted endovascular treatment of atherosclerotic stenosis,it has an important application value.