Song Jae W, Rafla Samuel D, Obusez Emmanuel C, Raymond Scott B, Gurol Edip M, Schaefer Pamela W, Romero Javier M
Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
J Clin Neurosci. 2019 May;63:278-280. doi: 10.1016/j.jocn.2019.01.008. Epub 2019 Jan 22.
Vessel wall MR imaging (VWI) may be able to highlight vulnerable intracranial atherosclerosis with vessel wall enhancement thereby serving as a biomarker for symptomatic prestenotic intracranial atherosclerotic disease. We present a case of intracranial hemorrhage presumably due to intracranial atherosclerotic disease (ICAD) identified by VWI and silent on lumen-based imaging modalities. A 66-year-old female presented with sudden onset headache and dysarthria. A head CT showed intracranial hemorrhage centered in the right basal ganglia. Further imaging by CT angiography, MR angiography and a conventional catheter angiogram were negative. MRI of the brain, including VWI, showed abnormal enhancement in the right middle cerebral artery vessel wall, suggesting intracranial atherosclerotic changes in a prestenotic vessel. As a potential noninvasive screening test, VWI could impact patients with ICAD and become part of a stroke risk stratification algorithm.
血管壁磁共振成像（VWI）或许能够通过血管壁强化凸显易损性颅内动脉粥样硬化，从而作为有症状的狭窄前颅内动脉粥样硬化疾病的生物标志物。我们报告一例颅内出血病例，推测其病因是颅内动脉粥样硬化疾病（ICAD），该病例通过VWI得以确诊，而基于管腔的成像方式则未显示异常。一名66岁女性突发头痛和构音障碍。头部CT显示颅内出血，以右侧基底节为中心。CT血管造影、磁共振血管造影和传统导管血管造影的进一步检查结果均为阴性。包括VWI在内的脑部MRI显示右侧大脑中动脉血管壁异常强化，提示狭窄前血管存在颅内动脉粥样硬化改变。作为一种潜在的无创筛查测试，VWI可能会对ICAD患者产生影响，并成为卒中风险分层算法的一部分。
