Comparison of imaging findings on three-dimensional black-blood enhanced MR imaging between intracranial atherosclerotic occlusion and thrombotic occlusion

Jooyeon Bhin; Hyo Sung Kwak; Seung Bae Hwang; Gyung Ho Chung

doi:10.1016/j.jstrokecerebrovasdis.2022.106877

Comparison of imaging findings on three-dimensional black-blood enhanced MR imaging between intracranial atherosclerotic occlusion and thrombotic occlusion

J Stroke Cerebrovasc Dis. 2023 Jan;32(1):106877. doi: 10.1016/j.jstrokecerebrovasdis.2022.106877. Epub 2022 Nov 10.

Authors

Jooyeon Bhin¹, Hyo Sung Kwak², Seung Bae Hwang³, Gyung Ho Chung⁴

Affiliations

¹ Medical Student, Jeonbuk National University Medical School, Korea. Electronic address: dju85@naver.com.
² Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Korea. Electronic address: kwakhs8140@gmail.com.
³ Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Korea. Electronic address: sbh1010@jbnu.ac.kr.
⁴ Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Korea. Electronic address: chunggh@jbnu.ac.kr.

PMID: 36370507
DOI: 10.1016/j.jstrokecerebrovasdis.2022.106877

Abstract

Purpose: The purpose of this study was to compare the imaging findings on three-dimensional (3D) black-blood (BB) contrast-enhanced MR imaging between intracranial atherosclerotic occlusion (IAO) and thrombotic occlusion (TO) of the middle cerebral artery (MCA) territory.

Materials and methods: From August 2020 to September 2021, we retrospectively reviewed the BB contrast-enhanced MR imaging of patients visiting the emergency room for evaluation of acute ischemic stroke. In total, 77 patients with complete occlusion of the MCA territory on 3D BB contrast-enhanced MR imaging and cerebral angiography were enrolled in this study. We divided the IAO and TO groups according to occlusion causes based on angiography findings.

Results: Of 77 patients, 44 (57.1%) had an IAO in the M1 and M2 and 33 had a TO. Lesion length contrast enhancement (CE) in patients with a TO was significantly longer than that in patients with an IAO (18.95 mm [IQR: 20.91] vs. 7.1 mm [8.92], p <0.001). Overall, 38 (39.4%) patients showed a disconnection of CE on 3D BB contrast-enhanced MR imaging, and 35 showed CE before and after the stenotic or thrombotic lesion. Symptomatic lesions on diffusion-weighted imaging in the TO group were significantly higher than that of the IAO group (97.0% vs, 70.5%, p = 0.003).

Conclusion: The long segment CE on 3D BB contrast-enhanced MR imaging was related to TO of MCA. CE before and after a stenotic or thrombotic lesion is a common finding on 3D BB contrast-enhanced MR imaging.

Keywords: Atherosclerosis; Black blood imaging; Contrast; Magnetic resonance imaging; Stroke.

MeSH terms

Contrast Media
Humans
Imaging, Three-Dimensional / methods
Intracranial Arteriosclerosis* / diagnostic imaging
Ischemic Stroke*
Magnetic Resonance Angiography / methods
Magnetic Resonance Imaging / methods
Retrospective Studies
Stroke* / pathology

Substances

Contrast Media