3.0T MR Imaging of the Cranial Arterial Wall for the Strategy of Stroke Prevention

Abstract

3.0T refined MRI reveals the anatomical structures clearly. Operative findings correspond well with MRI findings. The authors have used this equipment for prevention of stroke. Especially evaluation of the arterial wall is important for this purpose. Showing illustrative cases including operative ones, the authors discuss the MRI findings and strategy of treatment. The examinations of the Carotid artery (CA) and vertebro-basilar artery (VBA) were performed with 3.0T MRI (Philips Achiva 3.0T, Holland). Specialized sequences for each arterial wall were planned after TOF-MRA screening. The sequences include T1, T2 VISTA (3D Fatsaturation Volume ISotropic Turbospinecho Acquisition), mPROSET (Multiple Principle Selective Excitation Technique), B-FFE(Balanced Fast Field Echo) and T1 and T2 Black Blood. Intentionally directed pictures were acquired with reconstruction. Components of the plaque were estimated with the combination of the intensity of each picture. Distributions of carotid plaques were well demarcated and its components were diagnosed. Prognosis of each plaque was estimated and the surgical and/or non-surgical treatment plan was secured. Preoperative MRI plaque findings and the specimens from carotid endarterectomy (CEA) correlated well. The stability of the plaque could be evaluated, which afforded the decision of timing and method of operation. Lacerated walls of VBA dissection were well illustrated and strategies were planned. Intra-aneurysmal thrombus was revealed and its development was imaged. The wall of the unruptured aneurysm could be evaluated but not always. 3.0T MRI provides more anatomical and pathological information than conventional MRI. Prognosis of each lesion could be estimated. Routine examination of the cranial arterial wall contributes to the prevention of stroke.