Anatomical Variations of the Proximal Segment of Middle Cerebral Artery and their Clinical Significance: Three Dimensional Magnetic Resonance Angiography study in Egyptians

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Walaa Sayed ◽  
Sherif Arsanyos ◽  
Mohamed Shabaan
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Middle Cerebral Artery ◽  
Clinical Significance ◽  
Cerebral Artery ◽  
Three Dimensional ◽  
Anatomical Variations ◽  
Proximal Segment

scholarly journals Prediction of Cerebral Hyperperfusion after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis by Three-Dimensional-Time-of-Flight Magnetic Resonance Angiography in Adult Patients with Moyamoya Disease

2020 ◽  
Vol 49 (4) ◽  
pp. 396-403
Author(s):  
Taketo Nishizawa ◽  
Miki Fujimura ◽  
Masahito Katsuki ◽  
Shunji Mugikura ◽  
Ryosuke Tashiro ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Signal Intensity ◽  
Superficial Temporal Artery ◽  
Three Dimensional ◽  
Temporal Artery ◽  
Cerebral Hyperperfusion ◽  
Revascularization Surgery

Introduction: Superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis is an effective surgical procedure for adult patients with moyamoya disease (MMD) and is known to have the potential to prevent cerebral ischemia and/or hemorrhagic stroke. Cerebral hyperperfusion (CHP) syndrome is one of the serious complications of this procedure that can result in deleterious outcomes, such as delayed intracerebral hemorrhage, but the prediction of CHP before revascularization surgery remains challenging. The present study evaluated the diagnostic value of preoperative three-dimensional (3D)-time-of-flight (TOF) magnetic resonance angiography (MRA) for predicting CHP after STA-MCA anastomosis for MMD. Materials and Methods: The signal intensity of the peripheral portion of the intracranial major arteries, such as the anterior cerebral artery (ACA), MCA, and posterior cerebral artery (PCA) ipsilateral to STA-MCA anastomosis, on preoperative MRA was graded (0–2 in each vessel) according to the ability to visualize each vessel on 97 affected hemispheres in 83 adult MMD patients. Local cerebral blood flow (CBF) at the site of anastomosis was quantitatively measured by N-isopropyl-p-[123I]-iodoamphetamine single-photon emission computed tomography 1 and 7 days after surgery, in addition to the preoperative CBF value at the corresponding area. Then, we investigated the correlation between the preoperative MRA score and the development of CHP. Results: The CHP phenomenon 1 day after STA-MCA anastomosis (local CBF increase over 150% compared with the preoperative value) was evident in 27 patients (27/97 hemispheres; 28%). Among them, 8 (8 hemispheres) developed CHP syndrome. Multivariate analysis revealed that the hemispheric MRA score (0–6), the summed ACA, MCA, and PCA scores for the affected hemisphere, was significantly associated with the development of CHP syndrome (p = 0.011). The hemispheric MRA score was also significantly correlated with the CHP phenomenon, either symptomatic or asymptomatic (p < 0.001). Conclusion: The signal intensity of the intracranial major arteries, including the ACA, MCA, and PCA, on preoperative 3D-TOF MRA may identify adult MMD patients at higher risk for CHP after direct revascularization surgery.

scholarly journals The Use of Pointwise Encoding Time Reduction With Radial Acquisition MRA to Assess Middle Cerebral Artery Stenosis Pre- and Post-stent Angioplasty: Comparison With 3D Time-of-Flight MRA and DSA

2021 ◽  
Vol 8 ◽  
Author(s):  
Feifei Zhang ◽  
Yuncai Ran ◽  
Ming Zhu ◽  
Xiaowen Lei ◽  
Junxia Niu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Magnetic Resonance Angiography ◽  
Flow Visualization ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Time Of Flight ◽  
Intervention Evaluation ◽  
Tof Mra ◽  
Angioplasty And Stenting

Background and Purpose: 3D pointwise encoding time reduction magnetic resonance angiography (PETRA-MRA) is a promising non-contrast magnetic resonance angiography (MRA) technique for intracranial stenosis assessment but it has not been adequately validated against digital subtraction angiography (DSA) relative to 3D-time-of-flight (3D-TOF) MRA. The aim of this study was to compare PETRA-MRA and 3D-TOF-MRA using DSA as the reference standard for intracranial stenosis assessment before and after angioplasty and stenting in patients with middle cerebral artery (MCA) stenosis.Materials and Methods: Sixty-two patients with MCA stenosis (age 53 ± 12 years, 43 males) underwent MRA and DSA within a week for pre-intervention evaluation and 32 of them had intracranial angioplasty and stenting performed. The MRAs' image quality, flow visualization within the stents, and susceptibility artifact were graded on a 1–4 scale (1 = poor, 4 = excellent) independently by three radiologists. The degree of stenosis was measured by two radiologists independently on DSA and MRAs.Results: There was an excellent inter-observer agreement for stenosis assessment on PETRA-MRA, 3D-TOF-MRA, and DSA (ICCs &gt; 0.90). For pre-intervention evaluation, PETRA-MRA had better image quality than 3D-TOF-MRA (3.87 ± 0.34 vs. 3.38 ± 0.65, P &lt; 0.001), and PETRA-MRA had better agreement with DSA for stenosis measurements compared to 3D-TOF-MRA (r = 0.96 vs. r = 0.85). For post-intervention evaluation, PETRA-MRA had better image quality than 3D-TOF-MRA for in-stent flow visualization and susceptibility artifacts (3.34 ± 0.60 vs. 1.50 ± 0.76, P &lt; 0.001; 3.31 ± 0.64 vs. 1.41 ± 0.61, P &lt; 0.001, respectively), and better agreement with DSA for stenosis measurements than 3D-TOF-MRA (r = 0.90 vs. r = 0.26). 3D-TOF-MRA significantly overestimated the stenosis post-stenting compared to DSA (84.9 ± 19.7 vs. 39.3 ± 13.6%, p &lt; 0.001) while PETRA-MRA didn't (40.6 ± 13.7 vs. 39.3 ± 13.6%, p = 0.18).Conclusions: PETRA-MRA is accurate and reproducible for quantifying MCA stenosis both pre- and post-stenting compared with DSA and performs better than 3D-TOF-MRA.

scholarly journals Hemodynamic Significance of Internal Carotid or Middle Cerebral Artery Stenosis Detected on Magnetic Resonance Angiography

2015 ◽  
Vol 56 (6) ◽  
pp. 1686 ◽  
Author(s):  
Hyo Jung Seo ◽  
Jefferson R. Pagsisihan ◽  
Jin Chul Paeng ◽  
Seung Hong Choi ◽  
Gi Jeong Cheon ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Artery Stenosis ◽  
Middle Cerebral Artery Stenosis

Asymptomatic middle cerebral artery stenosis diagnosed by magnetic resonance angiography

2004 ◽  
Vol 46 (1) ◽  
pp. 49-53 ◽  
Author(s):  
W. R. Selman ◽  
D. M. D. Landis ◽  
O. O. Zaidat ◽  
D. B. Zahuranec ◽  
E. E. Ubogu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Stenosis ◽  
Middle Cerebral Artery Stenosis

scholarly journals Stent-assisted coil embolization on down-the-barrel view with spring-shaped microcatheter in patient with M1 ultrawide necked circumferential aneurysm

2018 ◽  
pp. bcr-2017-013597
Author(s):  
Hyo Sung Kwak ◽  
Jung Soo Park ◽  
Eun Jeong Koh
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Middle Cerebral Artery ◽  
Digital Subtraction Angiography ◽  
Cerebral Artery ◽  
Coil Embolization ◽  
Digital Subtraction ◽  
Safe Technique ◽  
Delayed Complications

Herein, we describe a technique for stent-assisted coil embolization with a spring-shaped microcatheter in a patient with an M1 ultrawide-necked circumferential aneurysm in the middle cerebral artery (MCA). A 49-year-old man was referred for treatment of an incidentally detected M1 large-circumference aneurysm on magnetic resonance angiography. Subsequent digital subtraction angiography revealed an 18.2×16.5 mm ultrawide-necked circumferential aneurysm on the distal M1 portion of the left MCA, and we planned stent-assisted coil embolization using a spring-shaped microcatheter. After we deployed the stent, we performed coil embolization under the down-the-barrel view by pulling out the microcatheter little by little. Using this technique, we could fill the coil mass evenly into the aneurysmal sac around the stent. And there were no immediate or delayed complications after the procedure. Stent-assisted coiling using a spring-shaped microcatheter is a useful and safe technique for treating ultrawide-necked circumferential aneurysm or fusiform aneurysms.

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