Abstract Details

Title High Resolution Magnetic Resonance Imaging in Symptomatic Intracranial Atherosclerosis: A Study in Time

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 253

Objective

Background BACKGROUND: High-resolution-3-Tesla Magnetic Resonance Imaging with Gadolinium contrast (HR-MRI) is a non-invasive method to look at intracranial vessel wall characteristics. Intracranial atherosclerosis (IA) is a well known cause of ischemic stroke as well as recurrent strokes.

Design/Methods DESIGN/METHODS: A retrospective analysis of patients with ischemic stroke due to intracranial atherosclerosis that underwent HR-MRI at our institution was performed. Inclusion criteria were patient who had ischemic stroke due to intracranial vessel stenosis which was clinically deemed to be due to atherosclerosis and had at least two HR-MRI at different time periods. Patients with laboratory testing or history suggestive of vasculitis were excluded. Demographics, clinical presentation, laboratory testing, imaging studies and outcomes were collected.

Results RESULTS: We identified six patients (66% females, Median age 51.5 years) that met inclusion criteria. All patients had at least two vascular risk factors. Initial HR-MRI, which was done within a month in most patients, showed vessel wall enhancement in the symptomatic vessel of interest (83.3% anterior circulation). Median follow up scan time was 8.5 months (Range: 2-15 months). At follow up, two patients (33%) had resolution of the enhancement in the vessel of interest and had no further clinical cerebrovascular events. Of the remaining 4 patients (66%) who still continued to have vessel wall enhancement on follow up, only one had recurrent ischemic strokes involving the same vascular territory.

Conclusions CONCLUSIONS: Our study shows that HR-MRI may be a potentially useful tool to follow up IA in high risk patients. However, it is unclear why the vessel wall enhancement persists in some cases in spite of a good clinical outcome. Prospective studies utilizing this modality may help us understand the disease process and guide treatment.

Authors/Disclosures
Russell M. Cerejo, MD (Allegheny health Network) PRESENTER	Dr. Cerejo has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Ischemaview.
	No disclosure on file
Silva Markovic-Plese, MD, FAAN (Thomas Jefferson University)	Dr. Markovic-Plese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Markovic-Plese has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi.
	No disclosure on file
	No disclosure on file
Ken Uchino, MD (Cleveland Clinic Foundation)	Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aboott Laboratories, Inc.. Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACP JOURNAL CLUB. The institution of Dr. Uchino has received research support from NIH.

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