scholarly journals Luminal and Wall Changes in Intracranial Arterial Lesions for Predicting Stroke Occurrence

Stroke ◽  
2020 ◽  
Vol 51 (8) ◽  
pp. 2495-2504 ◽  
Author(s):  
Hyung Jun Kim ◽  
Eun-Hyeok Choi ◽  
Jong-Won Chung ◽  
Jae-Hwan Kim ◽  
Ye Sel Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Moyamoya Disease ◽  
Ring Finger ◽  
Stroke Recurrence ◽  
Large Artery ◽  
Gene Variant ◽  
Resonance Imaging ◽  
Asian Patients

Background and Purpose: Luminal imaging (degree of stenosis) currently serves as the gold standard to predict stroke recurrence and guide therapeutic strategies in patients with intracranial large artery diseases (ILADs). We comparatively evaluated the importance of vessel wall and luminal changes in predicting stroke occurrence. Methods: Consecutive patients with ILAD in the proximal middle cerebral artery or distal internal carotid artery without proximal sources of embolism from the carotid and heart underwent time-of-flight magnetic resonance angiography, high-resolution magnetic resonance imaging, and the ring finger protein 213 ( RNF213 ) gene variant test. Patients were followed up for >3 months. Results: Of the 675 patients, 241 (35.7%) had atherosclerotic ILAD and 434 (64.3%) showed nonatherosclerotic ILAD (315 [46.7%] moyamoya disease cases and 119 [17.6%] dissection cases). The RNF213 variant was detected in 74.9%, 33.6%, and 3.4% patients with moyamoya disease, atherosclerosis, and dissection, respectively. Three hundred (44.4%) patients had asymptomatic ILAD, whereas 375 (55.6%) patients had symptomatic ILAD. Multivariate analysis showed that vessel enhancement and etiological subtypes, not degree of stenosis, determined by high-resolution magnetic resonance imaging and RNF213 gene variant analysis were independently associated with symptomatic ILAD. The presence of the RNF213 variant was also independently associated with recurrent cerebrovascular events. Conclusions: This study demonstrates the prevalence of nonatherosclerotic ILAD in East Asian patients with ILAD. Unlike luminal changes, wall changes determined by high-resolution magnetic resonance imaging and presence of the RNF213 variant could predict stroke occurrence in patients with ILADs.

Abstract WMP71: Moyamoya-atherosclerosis Syndrome: Clinical and High-resolution Magnetic Resonance Imaging Features

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lian Duan ◽  
Wei-Hai Xu ◽  
Cong Han
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Moyamoya Disease ◽  
Treatment Strategies ◽  
Diagnostic Process ◽  
Imaging Features ◽  
Intracranial Atherosclerosis ◽  
Resonance Imaging

Introduction: The diagnosis in the patients with angiographic moyamoya findings and atherogenic risk factors is challenging. In this study, we try to incorporate high-resolution magnetic resonance imaging (HRMRI) into the diagnostic process of intracranial atherosclerosis associated moyamoya syndrome. Methods: From March 2013 to March 2014, HRMRI was consecutively performed on adult patients with angiographic moyamoya. The patients were classified as moyamoya - plaques (MMD-P) if a plaque could be identified or as moyamoya - no plaques (MMD-NP) if a plaque could not be identified. The angiography, HRMRI findings and atherogenic risk factors of these patients were analyzed. Results: Fifty-one patients (mean age 39±9, 20 males) were enrolled. On traditional angiography, probable intracranial atherosclerosis was identified in 5 patients, no definite diagnosis in 12 patients, and moyamoya disease in 34 patients. On HRMRI, 15 out of 32 patients with risk factors and 4 out of 19 patients without risk factors were found to have plaques and were diagnosed as MMD-P, while the other 32 patients were diagnosed as MMD-NP. The MMD-P patients were more likely to be older and male and were less likely to have cerebral hemorrhage and a history of disease progression. Conclusions: Our study suggests that HRMRI can help diagnose intracranial atherosclerosis more accurately in moyamoya disease patients with atherogenic risk factors. The distinct clinical features between MMD-P and MMD-NP patients suggest different underlying pathophysiology and therefore potentially different treatment strategies.

scholarly journals High-resolution Magnetic Resonance Imaging of Moyamoya Disease

2015 ◽  
Vol 128 (23) ◽  
pp. 3231-3237 ◽  
Author(s):  
Le-Bao Yu ◽  
Qian Zhang ◽  
Zhi-Yong Shi ◽  
Ming-Qiu Wang ◽  
Dong Zhang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Moyamoya Disease ◽  
Resonance Imaging

Intracranial plaque enhancement from high resolution vessel wall magnetic resonance imaging predicts stroke recurrence

2016 ◽  
Vol 11 (2) ◽  
pp. 171-179 ◽  
Author(s):  
Jeong-Min Kim ◽  
Keun-Hwa Jung ◽  
Chul-Ho Sohn ◽  
Jangsup Moon ◽  
Jung-Hwan Shin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Stroke Recurrence ◽  
Resonance Imaging

scholarly journals Role of the RNF213 Variant in Vascular Outcomes in Patients With Intracranial Atherosclerosis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hyung Jun Kim ◽  
Eun‐Hyeok Choi ◽  
Jong‐Won Chung ◽  
Jae‐Hwan Kim ◽  
Ye Sel Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
East Asian ◽  
Ring Finger ◽  
Imaging Features ◽  
Intracranial Atherosclerosis ◽  
Resonance Imaging ◽  
Cerebrovascular Events ◽  
Tandem Lesions

Background The RNF213 ( ring finger protein 213 gene) variant R4810K is a susceptibility allele not only for Moyamoya disease (MMD) but also for intracranial atherosclerosis (ICAS) in East Asian populations. We hypothesized that this variant would affect the distribution of ICAS and recurrence of cerebrovascular events. Methods and Results We conducted a prospective study of patients with ICAS and MMD using high‐resolution magnetic resonance imaging and RNF213 R4810K genotyping. Patients were included in the ICAS group when relevant plaques existed on high‐resolution magnetic resonance imagingand in the MMD group when they carried the variant and high‐resolution magnetic resonance imaging showed no plaques but characteristic features of MMD. We compared clinical and neuroimaging features of patients with ICAS‐ RNF213 + with patients with ICAS‐ RNF213 − and of patients with MMD. Of 477 patients, 238 patients were in the ICAS group and 239 were in the MMD group. Among patients with ICAS, 79 patients (33.2%) were in the ICAS‐ RNF213 + group and 159 (66.8%) in the ICAS‐ RNF213 − group. Tandem lesions were significantly more common in the ICAS‐ RNF213+ group than in the ICAS‐ RNF213 − group (40.3% versus 72.2%, P <0.001), and their distributions were similar between the ICAS‐ RNF213+ and MMD groups. The presence of the R4810K variant (hazard ratio [HR], 3.203; 95% CI, 1.149–9.459; P =0.026) and tandem lesions (≥3) (HR, 8.315; 95% CI, 1.930–39.607; P =0.005) were independently associated with recurrent cerebrovascular events. Conclusions Patients with ICAS carrying the RNF213 R4810K variant showed clinical and imaging features distinct from patients with ICAS without the variant, suggesting that the R4810K variant plays a role in intracranial atherosclerosis in East Asian patients.

Functional information from magnetic resonance imaging

1995 ◽  
Vol 53 ◽  
pp. 84-85
Author(s):  
Alan P. Koretsky ◽  
Afonso Costa e Silva ◽  
Yi-Jen Lin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Cancer Biology ◽  
Imaging Modality ◽  
Magnetic Resonance Images ◽  
Great Success ◽  
Functional Information ◽  
Resonance Imaging ◽  
High Resolution Mri

Magnetic resonance imaging (MRI) has become established as an important imaging modality for the clinical management of disease. This is primarily due to the great tissue contrast inherent in magnetic resonance images of normal and diseased organs. Due to the wide availability of high field magnets and the ability to generate large and rapidly switched magnetic field gradients there is growing interest in applying high resolution MRI to obtain microscopic information. This symposium on MRI microscopy highlights new developments that are leading to increased resolution. The application of high resolution MRI to significant problems in developmental biology and cancer biology will illustrate the potential of these techniques.In combination with a growing interest in obtaining high resolution MRI there is also a growing interest in obtaining functional information from MRI. The great success of MRI in clinical applications is due to the inherent contrast obtained from different tissues leading to anatomical information.

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