Abstract TP125: Intracranial Stenosis Subtypes in Patients Aged 45 Years or Younger

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Wei-Hai Xu ◽  
Yu-Yuan Xu ◽  
Ming-Li Li ◽  
Zheng-Yu Jin ◽  
Zhao-Yong Sun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Vessel Wall ◽  
Young Patients ◽  
Intracranial Stenosis ◽  
High Grade ◽  
Resonance Imaging ◽  
Atherosclerosis Risk ◽  
Vessel Wall Properties ◽  
Atherosclerosis Risk Factors ◽  
Middle Cerebral Artery Stenosis

Objective: Using high-resolution magnetic resonance imaging(HRMRI), we sought to examine the proportions of intracranial stenosis subtypes and their clinical relevance in young patients(≤45 years old). Methods: One hundred and twenty-nine consecutive patients (mean age 36±8 years) with middle cerebral artery stenosis and without Moyamoya disease were evaluated by HRMRI. The stenosis was classified as eccentric stenosis, concentric stenosis, and mixed stenosis if both eccentric and concentric stenosis occurred in one vessel. The clinical data and vessel wall properties were analyzed among the subtypes. Results: Eccentric stenosis was found in 86 (69.4%) patients, while concentric stenosis was found in 26 patients (21.0%) and mixed stenosis in 12(9.7%) patients. The patients with eccentric stenosis were older (p<0.001) and more likely had atherosclerosis risk factors (p=0.024). The patients with concentric stenosis were more likely female, and aged 35 years old or younger. All mixed stenosis were high-grade (>70%) stenotic. All concentric stenosis showed constrictive remodeling, while eccentric and mixed stenosis had heterogeneous remodeling types. In 34 patients with available enhanced images, ring enhancement was revealed in 8/9(88.9%) concentric stenosis and 5/5(100%) mixed stenosis, but only in 3/20(15%) eccentric stenosis (P<0.001). Ten of twelve (83.3%) patients with mixed stenosis were symptomatic, more frequently than the patients with eccentric stenosis (57.0%, p=0.072) and the patients with concentric stenosis (50%, p=0.052). Conclusions: The distinct vessel wall features among intracranial stenosis subtypes suggest heterogeneous pathophysiology. Further studies are required to investigate whether mixed stenosis is the most vulnerable subtype in young patients (≤45 years old).

Abstract T MP54: High-resolution Magnetic Resonance Imaging of Intracranial Stenosis in Patients Younger Than 35 Years

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Weihai Xu ◽  
Ming-Li Li ◽  
Shan Gao ◽  
Zheng-Yu Jin ◽  
Feng Feng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Wall Thickening ◽  
Resonance Imaging ◽  
Atherosclerotic Lesions ◽  
Atherosclerotic Stenosis ◽  
Atherosclerosis Risk ◽  
Atherosclerosis Risk Factors

Background: Using High-resolution magnetic resonance imaging(HRMRI), we aimed to investigate the etiology of intracranial stenosis in patients younger than 35 years. Methods: Fifty-four consecutive patients (mean age,29±6 years) with middle cerebral artery stenosis were evaluated by HRMRI. The morphology of artery lesions and clinical data were analyzed. Probable atherosclerotic plaques were diagnosed by the presence of eccentric wall thickening. Probable non-atherosclerotic lesions were diagnosed by the presence of concentric wall thickening and absence of plaques.On quantitative analysis, when constrictive remodeling can be identified by visual inspection, vessel shrinkage was defined. Results: Plaques were found in 32 (59%) patients, including 13 patients without any atherosclerosis risk factors. The patients with a plaque tended to be older (p=0.061), male (p=0.013), and more likely have atherosclerosis risk factors(59% vs. 23%, p=0.012), expansive artery remodeling (37.5% vs. 0,p<0.001), and infarctions (75% vs. 45%, p=0.044). The non-atherosclerotic lesions more often displayed vessel shrinkage (100% vs. 31%, p<0.001) and concentric wall enhancement (83% vs.13%, p<0.001). Conclusion: In this study, atherosclerosis accounted for a high percentage of intracranial artery stenosis in patients younger than 35 years when HRMRI was introduced into the diagnostic setting. Intracranial non-atherosclerotic stenosis has distinct vascular pathophysiology from atherosclerotic stenosis and is often free from stroke.

scholarly journals High-Resolution Vessel Wall Magnetic Resonance Imaging of Small Unruptured Intracranial Aneurysms

2021 ◽  
Vol 10 (2) ◽  
pp. 225
Author(s):  
Łukasz Zwarzany ◽  
Ernest Tyburski ◽  
Wojciech Poncyljusz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Resonance Imaging ◽  
Aneurysm Wall ◽  
Conventional Risk Factors

Background: We decided to investigate whether aneurysm wall enhancement (AWE) on high-resolution vessel wall magnetic resonance imaging (HR VW-MRI) coexists with the conventional risk factors for aneurysm rupture. Methods: We performed HR VW-MRI in 46 patients with 64 unruptured small intracranial aneurysms. Patient demographics and clinical characteristics were recorded. The PHASES score was calculated for each aneurysm. Results: Of the 64 aneurysms, 15 (23.4%) showed wall enhancement on post-contrast HR VW-MRI. Aneurysms with wall enhancement had significantly larger size (p = 0.001), higher dome-to-neck ratio (p = 0.024), and a more irregular shape (p = 0.003) than aneurysms without wall enhancement. The proportion of aneurysms with wall enhancement was significantly higher in older patients (p = 0.011), and those with a history of prior aneurysmal SAH. The mean PHASES score was significantly higher in aneurysms with wall enhancement (p < 0.000). The multivariate logistic regression analysis revealed that aneurysm irregularity and the PHASES score are independently associated with the presence of AWE. Conclusions: Aneurysm wall enhancement on HR VW-MRI coexists with the conventional risk factors for aneurysm rupture.

Atherosclerosis risk factors in young patients formerly treated for idiopathic nephrotic syndrome

2008 ◽  
Vol 24 (3) ◽  
pp. 549-554 ◽  
Author(s):  
Maria H. Kniażewska ◽  
Anna K. Obuchowicz ◽  
Tomasz Wielkoszyński ◽  
Joanna Żmudzińska-Kitczak ◽  
Katarzyna Urban ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Young Patients ◽  
Atherosclerosis Risk ◽  
Atherosclerosis Risk Factors

Abstract WMP55: Vessel Wall Characteristics using High Resolution Magnetic Resonance Imaging in Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Russell Cerejo ◽  
Seby John ◽  
Tariq Hammad ◽  
Emmanuel C. Obusez ◽  
Rula Hajj-ali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Vessel Wall ◽  
Clinical Presentation ◽  
Wall Thickening ◽  
Resonance Imaging ◽  
Cns Vasculitis ◽  
Cerebral Vasoconstriction ◽  
Intracranial Vessel ◽  
Vessel Stenosis

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) and central nervous system (CNS) vasculitis often have similar initial clinical presentation, laboratory findings and imaging features creating a diagnostic dilemma. High-resolution-3-Tesla Magnetic Resonance Imaging with Gadolinium contrast (HR-MRI) is a non-invasive method to look at intracranial vessel wall characteristics. Methods: A retrospective analysis of all patients with a diagnosis of RCVS or CNS vasculitis that underwent HR-MRI at our institution was performed. Inclusion criteria for RCVS were clinical presentation, no aneurysmal subarachnoid hemorrhage, normal cerebrospinal fluid and reversible multifocal intracranial vessel stenosis whereas criteria for CNS vasculitis were cases with positive brain biopsy or typical clinical presentation, course and laboratory markers with rheumatology and stroke neurology agreement in diagnosis. Demographics, clinical presentation, laboratory testing, imaging studies and outcomes were collected. Results: Eleven patients with RCVS [10 (90.9%) females, mean age 45.2] and 8 with CNS vasculitis [6 primary CNS vasculitis, 6 (75%) males, mean age 43.5] were included in the study. No abnormal vessel wall enhancement or thickening was seen in any of the RCVS patients in areas of vessel stenosis. Six (75%) of CNS vasculitis patients had vessel wall thickening or enhancement (p=0.001 for comparison to RCVS) and the remaining 2 patients had HR-MRI performed 6 and 10 years after diagnosis and chronic treatment. All RCVS patients who had follow up HR-MRI demonstrated resolution of the multifocal stenosis. Two out of 4 CNS vasculitis patients with subsequent HR-MRI imaging had decrease in vessel wall thickening and enhancement after immunosuppressive therapy. Conclusion: In acute stages of presentation, HR-MRI may be useful in differentiating RCVS from CNS vasculitis. It may also be useful in following the disease course to look for resolution of intracranial vessel stenosis in RCVS or treatment response in vasculitis. Further studies are needed to confirm the utility of HR-MRI in diagnosis and disease progression in RCVS and vasculitis.

Results of Irradiation in Patients with High-Grade Gliomas Evaluated by Magnetic Resonance Imaging

1995 ◽  
Vol 18 (4) ◽  
pp. 297-299 ◽  
Author(s):  
R. B. Seither ◽  
B. Jose ◽  
K. J. Paris ◽  
R. D. Lindberg ◽  
W. J. Spanos
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Grade ◽  
Resonance Imaging ◽  
High Grade Gliomas

scholarly journals Standard-Dose Atorvastatin Treatment in Patients With Symptomatic Middle Cerebral Artery Atherosclerotic Stenosis: A Vessel Wall Magnetic Resonance Imaging Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yejun Wu ◽  
Fangbing Li ◽  
Yilin Wang ◽  
Tianxiang Hu ◽  
Honghua Gao
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vessel Wall ◽  
Standard Dose ◽  
Density Lipoprotein ◽  
Statin Treatment ◽  
Resonance Imaging ◽  
Atorvastatin Treatment ◽  
Atherosclerotic Stenosis

Background and Purpose: Ischemic stroke can be caused by atherosclerotic lesions of the middle cerebral artery (MCA). Some studies have described the effects of statin treatment on carotid artery plaques, but little is known about the effects of statin treatment on MCA plaques. The purpose of this study was to validate the efficacy of standard-dose atorvastatin (20 mg/day) in patients with symptomatic MCA atherosclerotic stenosis (SMAS) in northern China.Materials and Methods: This study is a prospective, single-arm, single-center, 12-month follow-up observational study monitoring imaging, and clinical outcomes of standard-dose atorvastatin treatment among patients with SMAS. The primary outcomes were changes in vessel wall magnetic resonance imaging (VWMRI) and serum lipid profiles before and after (1, 3, 6, and 12 months) statin treatment.Results: A total of 46 patients were recruited for this study, and 24 patients completed the follow-up. During the follow-up period, serum non-high-density lipoprotein cholesterol concentrations gradually decreased in the patients. Fourteen patients (54.33%) had a reversal of MCA plaques and 10 patients (41.67%) had no significant progression of MCA plaques and remained stable at the follow-up endpoint. At the 12 months follow-up time-point, the treatment did not reverse vascular remodeling or change the shape and distribution of plaques. Altered serum low-density lipoprotein cholesterol (LDL-C) concentrations in patients were strongly associated with plaque reversal.Conclusion: Vessel wall magnetic resonance imaging could accurately characterize changes in MCA plaques after lipid-lowering therapy. Standard-dose atorvastatin treatment could stabilize and reverse plaques in northern Chinese patients with SMAS.

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