1-O12 Inter-reader agreement for assessing the circle of willis anatomy in patients with acute ischemic stroke using time of flight magnetic resonance angiography

Background Recent advances in high-resolution (HR) magnetic resonance angiography (MRA) using ultrahigh-field systems enable direct visualization of the lenticulostriate arteries (LSAs), which had been hardly achieved by conventional MRA. Hence, by using HR-MRA at 7 T, we attempted to assess occlusive changes in the LSAs in patients with LSA territorial infarcts. Methods We prospectively examined 34 consecutive patients with acute ischemic stroke in the LSA territory using a 7 T scanner. We measured the lengths of the relevant LSAs on HR-MRA and the diameters/volume of the infarcts and compared these between the patients with/without occlusive changes in the LSAs. Results On HR-MRA, occlusion of the LSAs was observed in 19 (59%) of 32 patients who were eligible for the analyses. The curved/straight lengths of the LSAs in the patients with LSA occlusion (23.1–31.1/17.8–24.3 mm) were significantly shorter than in those without apparent LSA occlusion (25.8–39.5/24.0–30.4 mm) ( P = 0.027/0.003). The anteroposterior/superoinferior diameters of the infarcts were significantly larger in the occluded-LSA group (14.5–21.4/14.9–22.2 mm) than in the intact-LSA group (10.9–16.8/10.8–16.2 mm) ( P = 0.041/0.011). In addition, the curved lengths of the relevant LSAs showed significant correlations with the superoinferior diameters of the infarcts ( r = 0.38, P = 0.034). Conclusion Occlusive changes in the LSAs were frequently found in patients with acute ischemic stroke within the LSA territory when using HR-MRA at 7 T and were substantially related to superoinferior extension of the infarcts.

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Examination of Structural Variations of the Circle of Willis by 3D Time-of-Flight Magnetic Resonance Angiography

Frontiers in Neuroscience ◽

10.3389/fnins.2020.00071 ◽

2020 ◽

Vol 14 ◽

Author(s):

Jing Li ◽

Jue Wang ◽

Xiao-er Wei ◽

Yu-wu Zhao ◽

Feng Wang ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Time Of Flight ◽

Circle Of Willis ◽

Structural Variations

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Computational Fluid Dynamics Analysis of Lateral Striate Arteries in Acute Ischemic Stroke Using 7T High-resolution Magnetic Resonance Angiography

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2019.104339 ◽

2019 ◽

Vol 28 (11) ◽

pp. 104339 ◽

Cited By ~ 1

Author(s):

Futoshi Mori ◽

Fujimaro Ishida ◽

Tatsunori Natori ◽

Haruna Miyazawa ◽

Hiroyuki Kameda ◽

...

Keyword(s):

Fluid Dynamics ◽

Computational Fluid Dynamics ◽

Ischemic Stroke ◽

Magnetic Resonance ◽

High Resolution ◽

Magnetic Resonance Angiography ◽

Acute Ischemic Stroke ◽

Dynamics Analysis ◽

Computational Fluid Dynamics Analysis

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Reclassifications of ischemic stroke patterns due to variants of the Circle of Willis

International Journal of Stroke ◽

10.1177/17474930211048381 ◽

2021 ◽

pp. 174749302110483

Author(s):

Ida Rangus ◽

Lennart S Milles ◽

Ivana Galinovic ◽

Kersten Villringer ◽

Heinrich J Audebert ◽

...

Keyword(s):

Ischemic Stroke ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Circle Of Willis ◽

Posterior Circulation ◽

Correct Identification ◽

Anterior Circulation ◽

Ischemic Lesion

Background Variants of the Circle of Willis (vCoW) may impede correct identification of ischemic lesion patterns and stroke etiology. We assessed reclassifications of ischemic lesion patterns due to vCoW. Methods We analyzed vCoW in patients with acute ischemic stroke from the 1000+ study using time-of-flight magnetic resonance angiography (TOF MRA) of intracranial arteries. We assessed A1 segment agenesis or hypoplasia in the anterior circulation and fetal posterior cerebral artery in the posterior circulation. Stroke patterns were classified as one or more-than-one territory stroke pattern. We examined associations between vCoW and stroke patterns and the frequency of reclassifications of stroke patterns due to vCoW. Results Of 1000 patients, 991 had evaluable magnetic resonance angiography. At least one vCoW was present in 37.1%. VCoW were more common in the posterior than in the anterior circulation (33.3% vs. 6.7%). Of 238 patients initially thought to have a more-than-one territory stroke pattern, 20 (8.4%) had to be reclassified to a one territory stroke pattern after considering vCoW. All these patients had fetal posterior cerebral artery and six (30%) additionally had carotid artery disease. Of 753 patients initially presumed to have a one-territory stroke pattern, four (0.5%) were reclassified as having more-than-one territory pattern. Conclusions VCoW are present in about one in three stroke patients and more common in the posterior circulation. Reclassifications of stroke lesion patterns due to vCoW occurred predominantly in the posterior circulation with fetal posterior cerebral artery mimicking multiple territory stroke pattern. Considering vCoW in these cases may uncover symptomatic carotid disease.

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Relationship Between Magnetic Resonance Angiography–Diffusion-weighted Imaging Mismatch and Clinical Outcome in Endovascular Treatment for Acute Ischemic Stroke: Subgroup Analysis of the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism–Japan Registry

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2013.12.053 ◽

2014 ◽

Vol 23 (6) ◽

pp. 1471-1476 ◽

Cited By ~ 8

Author(s):

Ichiro Deguchi ◽

Tomohisa Dembo ◽

Shinichi Yoshimura ◽

Nobuyuki Sakai ◽

Yasushi Okada ◽

...

Keyword(s):

Ischemic Stroke ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Clinical Outcome ◽

Endovascular Treatment ◽

Acute Ischemic Stroke ◽

Subgroup Analysis ◽

Diffusion Weighted Imaging ◽

Diffusion Weighted

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Assessment of thrombus length in acute ischemic stroke by post-contrast magnetic resonance angiography

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2017-013454 ◽

2017 ◽

Vol 10 (8) ◽

pp. 756-760 ◽

Cited By ~ 2

Author(s):

Ramanan Ganeshan ◽

Alexander H Nave ◽

Jan F Scheitz ◽

Katharina A Schindlbeck ◽

Karl Georg Haeusler ◽

...

Keyword(s):

Ischemic Stroke ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

Vessel Occlusion ◽

Clinical Trial Registration ◽

Post Contrast ◽

Arterial Thrombus ◽

Contrast Magnetic Resonance

ObjectivesPost-contrast magnetic resonance angiography (PC-MRA) enables visualization of vessel segments distal to an intra-arterial thrombus in acute ischemic stroke. We hypothesized that PC-MRA also allows clot length measurement in different intracranial vessels.MethodsPatients with MRI-confirmed ischemic stroke and intracranial artery occlusion within 24 hours of symptom onset were prospectively evaluated. PC-MRA was added to a standard stroke MRI protocol. Thrombus length was measured on thick slab maximum intensity projection images. Clinical outcome at hospital discharge was assessed by modified Rankin Scale (mRS).ResultsThirty-four patients (median age 72 years) presenting with a median National Institutes of Health Stroke Scale score of 11 and a median onset to imaging time of 116 min were included. PC-MRA enabled precise depiction of proximal and distal terminus of the thrombus in 31 patients (91%), whereas in three patients (9%) PC-MRA presented a partial occlusion. Median thrombus length in patients with complete occlusion was 9.9 mm. In patients with poor outcome (mRS ≥3) median thrombus length was significantly longer than in those with good outcome (mRS ≤2;P=0.011).ConclusionsPC-MRA demonstrates intra-arterial thrombus length at different vessel occlusion sites. Longer thrombus length is associated with poor clinical outcome.Clinical trial registrationNCT02077582; Results.

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