Application of 3.0T high-resolution magnetic resonance imaging for the diagnosis of stenotic vessel wall plaques in the middle cerebral artery: a study on fitness of professional athletes

Objective: To investigate the value of 3.0T high-resolution magnetic resonance imaging (HR-MRI) in the diagnosis of plaque in the vessel wall of middle cerebral artery stenosis. Methods: 41 patients with middle cerebral artery stenosis admitted from January 2018 to January 2020 were selected for the study, all of whom underwent HR-MRI, and the diagnostic results of digital subtraction angiography (DSA) were used as the gold standard to compare HR-MRI findings in middle cerebral artery stenosis with DSA diagnostic results. The NWI and responsible plaque heights of non-ischemic stroke and ischemic stroke patients at 6 months, 12 months, 18 months and 24 months after discharge were compared. Results: 41 patients were found to have stenosis in 49 middle cerebral arteries by DSA, including 33 cases of unilateral stenosis and 8 cases of bilateral stenosis. The diagnostic accuracy, specificity and sensitivity of HR-MRI in middle cerebral artery stenosis were 93.90% (77/82), 90.91% (30/33), 95.92% (47/49). There was no obvious distinction in NWI and responsible plaque height at 6, 12, 18 and 24 months after discharge in patients with ischemic stroke (P > 0.05). When comparing NWI and responsible plaque height at corresponding time points after discharge in non-ischemic stroke patients, the distinctions were not obvious (P > 0.05). Compared with the group of ischemic stroke, the non-ischemic stroke group NWI was lower at corresponding time points (P < 0.05). No obvious distinctions were found between the group of ischemic stroke and the group of non-ischemic stroke in terms of responsible plaque height at 6, 12, 18 and 24 months after discharge (P > 0.05). (AU)

The Asymmetry of White Matter Hyperintensity Burden Between Hemispheres Is Associated With Intracranial Atherosclerotic Plaque Enhancement Grade.

PURPOSE: The contribution of intracranial atherosclerotic stenosis (ICAS) to the development of white matter hyperintensities (WMHs) has not been fully elucidated. We aimed to retrospectively assess the relationship between WMH burden and unilateral ICAS by combined examination of lumen stenosis, plaque enhancement, and cerebral perfusion. MATERIALS AND METHODS: A cross-sectional study of 41 patients with symptomatic unilateral ICAS (mean age 57 ± 10 years; 26 males) was conducted. Detailed clinical data, including vascular risk factors, were obtained. WMH volume was derived from 3D-fluid-attenuated inversion recovery (3D-FLAIR) and was assessed by using a validated semi-automated protocol. Lumen stenosis, plaque enhancement, and cerebral perfusion (assessed on time-to-peak parameter using the Alberta Stroke Program Early CT score (TTP-ASPECTS) scale) were evaluated. The WMH volumes of peri-ventricular (PWMH) and deep (DWMH) white matter were calculated separately and compared between hemispheres. Associations between WMH volume (inter-hemispheric volume difference, ipsilateral and contralateral to the ICAS site separately), unilateral ICAS imaging metrics, and vascular risk factors were assessed by using linear regression. RESULTS: The DWMH volume ipsilateral to the ICAS site (ipsilateral DWMH volume) was significantly greater than that of the contralateral site (P < 0.001), while the PWMH volume difference between hemispheres did not reach statistical significance. The inter-hemispheric DWMH volume difference was significantly associated with a higher plaque enhancement grade (ß = 0.436, P = 0.005) and inversely associated with cerebral hypoperfusion (lower TTP-ASPECTS) (ß = -0.613, P < 0.001). In the between-subject multivariable regression analysis, while older age (ß = 0.323, P = 0.025), hypoperfusion (ß = -0.394, P = 0.007), and hypertension (ß = 0.378, P = 0.011) were independently associated with ipsilateral DWMH volume, plaque enhancement did not show an association with ipsilateral DWMH volume. The association between ipsilateral DWMH volume and lumen stenosis approached statistical significance (ß = 0.274, P = 0.084). CONCLUSION: The DWMH was attributed to chronic hypoperfusion secondary to atherosclerotic stenosis. The association between the asymmetry of deep white matter lesions and plaque enhancement might suggest that increased deep white matter lesions are those ischemic lesions, which are more prone to the development of stroke.