Delayed Enhancement of Intracranial Atherosclerotic Plaque Can Better Differentiate Culprit Lesions: A Multiphase Contrast-Enhanced Vessel Wall MRI Study

• DOI: 10.3174/ajnr.a8132
• Publication Date: 2024-02-22T20:10:18Z
• Authors: Beibei Sun; Lingling Wang; Xiao Li; Jin Zhang; Jianjian Zhang; Jiaqi Tian; Mahmud Mossa-Basha; Jianrong Xu; Yan Zhou; Huilin Zhao; Chengcheng Zhu
• Keywords: Culprit; Stroke; Contrast Enhancement

<h3>BACKGROUND AND PURPOSE:</h3> Intracranial plaque enhancement (IPE) identified by contrast-enhanced vessel wall MR imaging (VW-MR imaging) is an emerging marker of instability related to stroke risk, but there was no standardized timing for postcontrast acquisition. We aim explore the optimal using multiphase VW-MR and test its performance in differentiating culprit nonculprit lesions. <h3>MATERIALS METHODS:</h3> Patients with acute ischemic due intracranial were prospectively recruited undergo 1 precontrast phase 4 consecutive phases (9 minutes 13 seconds each phase). The signal intensity (SI) values CSF measured on determine index (PEI). dynamic changes PEI compared between plaques acquisitions. <h3>RESULTS:</h3> Thirty patients (aged 59 ± 10 years, 18 [60%] men) 113 included. average all significantly increased (up 14%) over phases. There (an increase 23%), this not observed plaques. For plaques, we that IPE second (cutoff = 0.83, AUC 0.829 [0.746–0.893]) exhibited superior accuracy when first 0.48; 0.768 [0.680–0.843]) (<i>P</i> .022). <h3>CONCLUSIONS:</h3> A 9-minute delay acquisition can maximize better differentiate In addition, have different temporal patterns, which should be evaluated future studies.