Detecting lenticulostriate artery lesions in patients with acute ischemic stroke using high-resolution MRA at 7 T

Abstract

Background

Recent advances in high-resolution (HR) magnetic resonance angiography (MRA) using ultrahigh-field systems enable direct visualization of the lenticulostriate arteries (LSAs), which had been hardly achieved by conventional MRA. Hence, by using HR-MRA at 7 T, we attempted to assess occlusive changes in the LSAs in patients with LSA territorial infarcts.

Methods

We prospectively examined 34 consecutive patients with acute ischemic stroke in the LSA territory using a 7 T scanner. We measured the lengths of the relevant LSAs on HR-MRA and the diameters/volume of the infarcts and compared these between the patients with/without occlusive changes in the LSAs.

Results

On HR-MRA, occlusion of the LSAs was observed in 19 (59%) of 32 patients who were eligible for the analyses. The curved/straight lengths of the LSAs in the patients with LSA occlusion (23.1–31.1/17.8–24.3 mm) were significantly shorter than in those without apparent LSA occlusion (25.8–39.5/24.0–30.4 mm) (P = 0.027/0.003). The anteroposterior/superoinferior diameters of the infarcts were significantly larger in the occluded-LSA group (14.5–21.4/14.9–22.2 mm) than in the intact-LSA group (10.9–16.8/10.8–16.2 mm) (P = 0.041/0.011). In addition, the curved lengths of the relevant LSAs showed significant correlations with the superoinferior diameters of the infarcts (r = 0.38, P = 0.034).

Conclusion

Occlusive changes in the LSAs were frequently found in patients with acute ischemic stroke within the LSA territory when using HR-MRA at 7 T and were substantially related to superoinferior extension of the infarcts.

Keywords

Magnetic resonance imaging ultrahigh field magnetic resonance angiography lenticulostriate artery acute stroke

Get full access to this article

View all access options for this article.

References

Marinkovic

Gibo

Milisavljevic

Cetkovic

. Anatomic and clinical correlations of the lenticulostriate arteries. Clin Anat 2001; 14: 190–195.

Umansky

Gomes

Dujovny

et al.

The perforating branches of the middle cerebral artery. A microanatomical study. J Neurosurg 1985; 62: 261–268.

Marinkovic

Milisavljevic

Kovacevic

et al.

Perforating branches of the middle cerebral artery. Microanatomy and clinical significance of their intracerebral segments. Stroke 1985; 16: 1022–1029.

Bang

. Considerations when subtyping ischemic stroke in Asian patients. J Clin Neurol 2016; 12: 129–136.

Caplan

. Lacunar infarction and small vessel disease: pathology and pathophysiology. J Stroke 2015; 7: 2–6.

Fisher

. Lacunar infarcts – a review. Cerebrovasc Dis 1991; 1: 311–320.

Nils

Henninger

Diogo

Louis

. Pathology of cerebral subcortical infarction. Int Rev Thromb 2012; 7: 238–237.

Kang

Park

Han

et al.

Imaging and analysis of lenticulostriate arteries using 7.0-Tesla magnetic resonance angiography. Magn Reson Med 2009; 61: 136–144.

Cho

Kang

Han

et al.

Observation of the lenticulostriate arteries in the human brain in vivo using 7.0T MR angiography. Stroke 2008; 39: 1604–1606.

10.

Kang

Park

Lee

et al.

Hypertension correlates with lenticulostriate arteries visualized by 7T magnetic resonance angiography. Hypertension 2009; 54: 1050–1056.

11.

Kang

Park

et al.

Lenticulostriate arteries in chronic stroke patients visualized by 7T magnetic resonance angiography. Int J Stroke 2010; 5: 374–380.

12.

Higashida

Furlan

Roberts

et al.

Technology assessment committee of the american society of interventional and therapeutic neuroradiology; technology assessment committee of the society of interventional radiology. Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke. Stroke 2003; 34: e109–e137.

13.

Fedorov

Beichel

Kalpathy-Cramer

et al.

3D Slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging 2012; 30: 1323–1341.

14.

Lammie

. Hypertension cerebral small vessel disease and stroke. Brain Pathol 2002; 12: 358–370.

15.

Caplan

. Intracranial branch atheromatous disease. A neglected, understudied, and underused concept. Neurogogy 1989; 39: 1246–1250.

16.

Macdonald

Kowalczuk

Johns

. Emboli enter penetrating arteries of monkey brain in relation to their size. Stroke 1995; 26: 1247–1250.

17.

Landi

Cella

Boccardi

et al.

Lacunar versus non-lacunar infarcts: pathogenetic and prognostic differences. J Neurol Neurosurg Psychiatry 1992; 55: 441–445.

18.

Futrell

. Lacunar infarction. Embolism is the key. Stroke 2004; 35: 1778–1779.

19.

Natori

Sasaki

Miyoshi

et al.

Intracranial plaque characterization in patients with acute ischemic stroke using pre- and post-contrast three-dimensional magnetic resonance vessel wall imaging. J Stroke Cerebrovasc Dis 2016; 25: 1425–1430.

20.

van der Kolk

AG1

Zwanenburg

Brundel

et al.

Intracranial vessel wall imaging at 7.0-T MRI. Stroke 2011; 42: 2478–2484.