Objective: To assess the feasibility and clinical value of high-resolution magnetic resonance imaging (HRMRI) in patients with symptomatic severe intracranial stenosis (SSIS).
Methods: HRMRI wasperformed with a 3.0 T MR scanner on 5 patients with symptomatic middle cerebral (n = 3) or basilar (n = 2) arterial stenosis of > or = 70% confirmed by DSA. Image diagnosis was made on the basis of HRMRI findings of vessel wall at the stenotic segment by 2 neuroradiologists blinded to patient's status.
Results: Three of the five patients were diagnosed to have advanced intracranial atherosclerosis based on the presence of a complex eccentric atherosclerotic plaque containing a large lipid-rich necrotic core with a heterogeneous post-contrast enhancement and with signs of ruptured fibrous cap. Two other patients were likely to suffer from non-atherosclerotic lesion. HRMRI revealed an iso-signal septum in the arterial lumen attaching to the slightly thickened arterial wall that was iso-signal with a homogeneous post-contrast enhancement in one patient and an obviously concentrically thickened arterial wall with hypo-intense signal on T1WI and slightly high signal on T2WI and PDWI and without any post-contrast enhancement in the remaining patient.
Conclusions: In vivo HRMRI in patients with SSIS is technically feasible. It provides detailed information of intracranial arterial wall at the stenotic segment.