1 Department of Neurology and Gerontology Iwate Medical University, Japan.
2 Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Japan.
Int J Stroke. 2019 Apr;14(3):290-297. doi: 10.1177/1747493018806163. Epub 2018 Oct 9.
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.
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.
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).
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.
利用超高场系统进行高分辨率(HR)磁共振血管造影(MRA)的最新进展使得直接可视化纹状体动脉(LSAs)成为可能,而这在传统 MRA 中几乎难以实现。因此,我们使用 7T HR-MRA 尝试评估 LSA 区域梗死患者 LSAs 的闭塞变化。
我们前瞻性地使用 7T 扫描仪检查了 34 例急性 LSA 区域缺血性脑卒中患者。我们在 HR-MRA 上测量了相关 LSAs 的长度以及梗死的直径/体积,并比较了 LSAs 闭塞与无闭塞患者之间的这些参数。
在可进行分析的 32 例患者中,19 例(59%)患者的 LSAs 存在闭塞。LSA 闭塞患者的 LSAs 弯曲/直线长度(23.1-31.1/17.8-24.3mm)明显短于无明显 LSA 闭塞患者(25.8-39.5/24.0-30.4mm)(P=0.027/0.003)。闭塞-LSA 组梗死的前后/上下直径明显大于完整-LSA 组(14.5-21.4/14.9-22.2mm)(P=0.041/0.011)。此外,相关 LSAs 的弯曲长度与梗死的上下直径呈显著相关(r=0.38,P=0.034)。
在使用 7T HR-MRA 时,LSA 区域急性缺血性脑卒中患者常发现 LSAs 闭塞变化,且与梗死的上下延伸有显著关系。