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. 2014 Aug;2(8):75.
doi: 10.3978/j.issn.2305-5839.2014.07.10.

Luminal thrombosis in middle cerebral artery occlusions: a high-resolution MRI study

Wei-Hai Xu  1 , Ming-Li Li  1 , Jing-Wen Niu  1 , Feng Feng  1 , Zheng-Yu Jin  1 , Shan Gao  1
Affiliations

Luminal thrombosis in middle cerebral artery occlusions: a high-resolution MRI study

Wei-Hai Xu et al. Ann Transl Med. 2014 Aug.

Abstract

Background and purpose: High signals within occluded vessels on T1-weighted fat-suppressed images (HST1) are highly suggestive of luminal thrombosis. We sought to investigate the feasibility of in vivo identification of luminal thrombosis in middle cerebral artery (MCA) occlusions using high-resolution magnetic resonance imaging (HR-MRI).

Methods: We retrospectively reviewed the HR-MRI data of 25 patients with unilateral symptomatic MCA occlusion. HST1 were defined as an area of high signal within the cross-section of occluded MCA, the intensity of which was >150% of the signal of adjacent muscles. The prevalence of HST1 and their relationship to infarct sizes and infarct patterns were analyzed.

Results: The average time from stroke onset to HR-MRI examination was 9±6 days. There were 18 (72%) occluded vessels with HST1 on HR-MRI. HST1 were observed in 5/7 patients with a large territory infarct (≥1/3 MCA distribution) and 13/18 patients without (P=0.37). In the patients with non-large territory infarcts, the presence of HST1 was similar in those with and without border zone infarcts (9/13 vs. 4/5, P=0.42).

Conclusions: It's feasible to in vivo identify luminal thrombosis in occluded MCA. HR-MRI is a potentially powerful tool for investigating the mechanisms of stroke due to MCA occlusions.

Keywords: Middle cerebral artery occlusion (MCA occlusion); cerebral infarct; magnetic resonance imaging; thrombosis.

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Figures

Figure 1
Figure 1
A patient with a large territory infarct (A) due to right middle cerebral artery (MCA) occlusion (B). On consecutive T2-weighted image slices of high-resolution MRI, normal flow void was absent in the right MCA (arrows, C and D). High signals within the MCA were noted on corresponding T1-weighted images suggesting probable luminal thrombosis (arrows, E and F).
Figure 2
Figure 2
A patient with multiple infarcts involving the internal border zone (A and B) due to right middle cerebral artery (MCA) occlusion (C). On T2-weighted (D) and corresponding T1-weighted (E) images of high-resolution MRI, the right MCA lost normal flow void. High signals within the MCA were seen on the distal neighboring T1-weighted image slice, suggesting probable luminal thrombosis (arrow, F).
See this image and copyright information in PMC

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