Arteries In Magnetic Resonance Angiography Research Articles

[Reduced Caliber of the Ophthalmic Artery in Magnetic Resonance Angiography in Patients after Retinal Artery Occlusion].

Retinal artery occlusion (RAO) is caused by embolic occlusion of retinal arteries. Previous strokes in the medical history were reported in up to 20% of patients. According to data from a computational blood flow analysis based on magnetic resonance imaging of a patient with RAO, about 90% of ascending emboli are washed into the brain, leaving speculations about further embolic sources for RAO, such as plaques or stenosis of the ophthalmic artery. The aim of this study was to examine the reduced caliber of the ophthalmic artery in magnetic resonance angiography (MRA). An analysis of a prospective case series of 9 patients with newly diagnosed RAO, presenting at the outpatient department. Magnetic resonance angiography of the brain, including the ophthalmic artery and carotid siphon was performed in all patients and evaluated by an experienced radiologist also specialised in neuroradiology. Outcomes were compared to an age-matched control group of 9patients without RAO. Four of 9 patients (44.4%) had a reduced caliber of the ophthalmic artery, two only at the side of RAO and another two bilateral. One of these cases also had a severe steno-occlusive disease of the internal carotid artery in the MRA, being in accordance with the results from duplex-sonography of the internal carotid artery. None of the patients in the control group had any signs of stenosis of the ophthalmic artery. Reduced caliber of the ophthalmic artery in MRA is present in almost half of patients with RAO and indicates that steno-occlusive disease of the ophthalmic artery could be a possible source of emboli, causing RAO.

Is Precise Targeting of the Recipient Artery in a Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Crucial?

To investigate the difference in treatment outcomes according to the method used to select the recipient artery in superficial temporal artery-middle cerebral artery (STA-MCA) anastomoses. We retrospectively analyzed the cases of 35 patients who underwent an STA-MCA anastomosis for internal carotid artery/MCA occlusion or stenosis. Patients were divided into two groups based on whether the recipient artery was precisely targeted by single-photon emission computed tomography (SPECT group) or less precisely targeted by visual assessment (Visual group). Then the bypass results in both groups were evaluated postoperatively based on changes in the regional cerebral blood flow (rCBF) and clinical outcomes. The delineated recipient artery in magnetic resonance angiography (MRA) matched the intraoperatively selected artery in 87.6% of the SPECT group cases and 83.3% of the Visual group cases. The SPECT group's digital subtraction angiography (DSA) findings coincided with the intraoperative selection in 76.9% of cases, and the MRA findings corresponded with the DSA findings in 92.3%. The postoperative areas with increased rCBF matched the perfused areas of intraoperatively selected arteries in 80.0% of the SPECT group cases and 77.8% of the Visual group cases. Postoperatively increased rCBF areas matching totally or partially with preoperative low-perfusion areas were observed in all cases. The present results revealed no significant differences in the change in rCBF in the low-perfusion area between the patients whose recipient arteries were selected by SPECT or visual assessment.

111. Reversible cerebral vasoconstriction syndrome associated with pregnancy in peripartum period

Introduction Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by reversible multifocal narrowing of the cerebral arteries, generally preceded by thunderclap headaches with or without associated neurological deficits. RCVS develops a unique set of clinical imaging. Though RCVS is typically considered benign and self-limited disease, some reports showed that the patients with RCVS had a higher proportion of non-benign outcomes. Here, we present 6 cases of RCVS associated with pregnancy. Methods Patients were retrospectively identified at TOYOTA Memorial Hospital, from 2010 to 2017. We diagnosed RCVS based on the presence of reversible vasoconstrictions of cerebral arteries in magnetic resonance angiography (MRA) and neurological symptoms in peripartum period. These vasoconstrictions disappeared in the follow-up MRA within 3 months. Clinical course of these patients were collected. Results The average age was 36.8 years old and 4 patients were primipara. Four patients were complicated with preeclampsia or eclampsia. Headache was the initial symptom in 3 patients and only 1 patient developed typical thunderclap headache. Four patients developed RCVS in peripartum period, and 2 patients in postpartum period. Intracranial hemorrhage and non-aneurysmal subarachnoid hemorrhage were detected in 1 patient respectively and PRES was detected in 3 patients. Magnesium sulfate was administered in 2 patients who presented with convulsion related to intracranial hemorrhage or eclampsia. No patient developed neurological sequela after the resolution of vasoconstrictions. Discussion Frequency of a typical thunderclap headache is relatively low in RCVS associated with pregnancy. RCVS can be associated with PRES and eclampsia closely. Prompt recognition and early imaging studies are essential for the diagnosis of RCVS associated with pregnancy.

112. Reversible cerebral vasoconstriction syndrome associated with pregnancy in peripartum period

Introduction Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by reversible multifocal narrowing of the cerebral arteries, generally preceded by thunderclap headaches with or without associated neurological deficits. RCVS develops a unique set of clinical imaging. Though RCVS is typically considered benign and self-limited disease, some reports showed that the patients with RCVS had a higher proportion of non-benign outcomes. Here, we present 6 cases of RCVS associated with pregnancy. Methods Patients were retrospectively identified at TOYOTA Memorial Hospital, from 2010 to 2017. We diagnosed RCVS based on the presence of reversible vasoconstrictions of cerebral arteries in magnetic resonance angiography (MRA) and neurological symptoms in peripartum period. These vasoconstrictions disappeared in the follow-up MRA within 3 months. Clinical course of these patients were collected. Results The average age was 36.8 years old and 4 patients were primipara. Four patients were complicated with preeclampsia or eclampsia. Headache was the initial symptom in 3 patients and only 1 patient developed typical thunderclap headache. Four patients developed RCVS in peripartum period, and 2 patients in postpartum period. Intracranial hemorrhage and non-aneurysmal subarachnoid hemorrhage were detected in 1 patient respectively and PRES was detected in 3 patients. Magnesium sulfate was administered in 2 patients who presented with convulsion related to intracranial hemorrhage or eclampsia. No patient developed neurological sequela after the resolution of vasoconstrictions. Discussion Frequency of a typical thunderclap headache is relatively low in RCVS associated with pregnancy. RCVS can be associated with PRES and eclampsia closely. Prompt recognition and early imaging studies are essential for the diagnosis of RCVS associated with pregnancy.

Comparison of Functional Outcome between Lacunar Infarction and Branch Atheromatous Disease in Lenticulostriate Artery Territory

Branch atheromatous disease (BAD) is differentiated from lacunar infarction (LI). BAD is often associated with neurological deterioration in the acute stage, but outcome of BAD patients in the chronic stage is unclear. We aimed to explore the outcome of BAD in the lenticulostriate artery (LSA) territory in comparison with those of LI from the viewpoint of activities of daily living (ADLs). We retrospectively investigated patients who were admitted within 3 days after stroke onset. The patients underwent daily rehabilitation during hospitalization. BAD in LSA territory was defined by the presence of lesion representing 3 or more consecutive horizontal slices in magnetic resonance imaging. Patients having atrial fibrillation or more than 50% stenosis of the large artery in magnetic resonance angiography were excluded. We retrieved data on clinical characteristics and evaluation from medical records. Subjects were 41 BAD and 35 LI patients. There was little difference in baseline characteristics. The National Institutes of Health Stroke Scale score was significantly higher in BAD patients (P < .05). The Barthel Index (BI) score and the Brunnstrom recovery stage were lower in BAD patients at admission (P < .05 and P < .05). Hospital stay was longer in BAD patients (P < .01), but the BI score at discharge was not different. To ambulate, 8 BAD and 1 LI patients depended on orthoses (P < .05), and 21 BAD and 7 LI patients used canes (P < .01). Multivariable analysis demonstrated that BAD lesion was correlated with AFO use independent of age and sex. BAD patients can obtain ADLs similar to LI patients. However, many BAD patients require canes and/or orthoses.

Automatic labeling of cerebral arteries in magnetic resonance angiography.

In order to introduce 4D flow magnetic resonance imaging (MRI) as a standard clinical instrument for studying the cerebrovascular system, new and faster postprocessing tools are necessary. The objective of this study was to construct and evaluate a method for automatic identification of individual cerebral arteries in a 4D flow MRI angiogram. Forty-six elderly individuals were investigated with 4D flow MRI. Fourteen main cerebral arteries were manually labeled and used to create a probabilistic atlas. An automatic atlas-based artery identification method (AAIM) was developed based on vascular-branch extraction and the atlas was used for identification. The method was evaluated by comparing automatic with manual identification in 4D flow MRI angiograms from 67 additional elderly individuals. Overall accuracy was 93%, and internal carotid artery and middle cerebral artery labeling was 100% accurate. Smaller and more distal arteries had lower accuracy; for posterior communicating arteries and vertebral arteries, accuracy was 70 and 89%, respectively. The AAIM enabled fast and fully automatic labeling of the main cerebral arteries. AAIM functionality provides the basis for creating an automatic and powerful method to analyze arterial cerebral blood flow in clinical routine.

Persistant Siyatik Arterde Tromboembolik İskeminin Cerrahi ve Endovasküler Girişim ile Başarılı Tedavisi

Elli yaşında erkek hasta, 1.5 aydır sağ bacakta ani başlayan soğukluk, hissizlik ve ağrı şikayetiyle başvurdu. Manyetik rezonans anjijyografide sağ süperfisyel femoral arterin orta uyluk seviyesinde sonlanarak popliteal arter olarak devam ettiği ve tromboze olduğu saptandı. Persistan siyatik arter çok nadir görülen vasküler bir anomalidir. Erken aterosklerotik değişiklikler, emboli ve anevrizma oluşumunda yatkınlığa neden olur. Biz bu çalışmada, popliteal ve krural arterlerinde akut arteriyel oklüzyon gelişen persistan siyatik arterli bir hastada, cerrahi ve endovasküler girişim ile başarılı bir şekilde tedavisini sunduk.

Rare variant of persistent primitive hypoglossal artery in magnetic resonance angiography

We present an extremely rare case of a variant of persistent primitive hypoglossal artery, which was found incidentally in magnetic resonance angiography during an examination for dizziness. This anastomotic vessel arose from the external carotid artery (ECA), not internal carotid artery, and entered the hypoglossal canal to basilar artery. To our knowledge, this is the fourth reported case of the persistent hypoglossal artery arising from the ECA. The possible clinical implications of this anomalous vessel are discussed.

Three-year follow-up of lumbar artery occlusion with magnetic resonance angiography in patients with sciatica: associations between occlusion and patient-reported symptoms.

Comparison of occlusion of lumbar arteries in magnetic resonance angiography (MRA) with patient-reported sciatica symptoms during a 3-year follow-up. To evaluate whether occlusion of lumbar arteries is associated with subjective pain symptoms and physical ability among sciatica patients. Cadaveric studies indicate that atherosclerotic manifestations of the abdominal aorta are associated with low back pain (LBP). Impaired blood flow may disturb diffusion of nutrients into the disc, causing degeneration and possibly back pain. Two-dimensional time-of-flight MRA was used to evaluate lumbar arteries at baseline and 3 years. The arteries on both sides (L1-L4) were evaluated visually and scored as normal, narrowed, or occluded. Incidence of new stenosis was estimated. The associations of stenosis with self-reported previous medical consultations, pain duration through the first year, and number of pain episodes through the last 2 years of follow-up were calculated. Additionally, leg and back pain (10-cm VAS), disability (Oswestry), and self-reported physical ability (self-efficacy) were inquired at 1, 2, and 3 years. In the statistical analysis, bivariate correlation, and the chi or Fisher's test were used. MRA was obtained at baseline for 147 patients and at 3 years for 134 patients. Baseline stenosis associated with intensity of back pain at 1 year, leg pain at 2 years, and self-efficacy at every follow-up assessment, but not with disability, previous LBP history, or future pain episodes. The associations of stenosis at 3 years were similar but weaker. Newly formed stenosis was associated with the preceding year's medical consultations due to LBP and prolonged LBP during the first follow-up year. Arterial stenosis is associated strongly and consistently with patient-estimated physical ability,but only slightly with subjective pain symptoms. Interestingly, new stenosis is preceded by pain symptoms. The evaluation of lumbar blood flow may thus be useful in clinical practice.

Vessel Tracking: Prospective Adjustment of Section-selective MR Angiographic Locations for Improved Coronary Artery Visualization over the Cardiac Cycle

To follow the motion of the coronary artery in magnetic resonance angiography, the authors evaluated vessel tracking, a method for prospective adjustment of the section location as a function of the delay from the cardiac trigger. In 10 volunteers and four patients, this method allowed the vessel to be maintained in the plane of acquisition throughout the cardiac cycle. With a single-phase multisection sequence, vessel-tracking acquisitions had an efficiency of 0.68 +/- 0.04 for both the right and left coronary arteries compared with 0.19 +/- 0.03 for a non-vessel-tracking acquisition (P < .001).