Vascular MR contrast enhancement in cerebrovascular disease

Abstract

Purpose: To determine the significance of vascular enhancement in stroke patients with and without permanent neurologic deficit.

Methods: We prospectively studied two groups of patients with spin-echo MR imaging before and after injection of gadopentetate dimeglumine. In the patients in group 1 (12 women, 22 men; age range, 32 to 76 years), who had permanent neurologic deficit caused by recent ischemic brain infarction, we obtained 3 to 13 serial MR images during follow-up examination. Group 2 consisted of 26 patients (14 women, 12 men; age range, 54 to 81 years) with transient neurologic deficit caused by angiographically proved high-grade stenosis or occlusion of the internal carotid artery.

Results: Vascular enhancement was present in 59% of patients in group 1 and in 65% of patients of group 2. In group 1, the frequency of vascular enhancement declined steadily over several weeks, but it was still present in single cases even after 3 months. Vascular enhancement correlated positively with the extent of brain infarction in group 1 and with the degree of carotid stenosis in group 2.

Conclusion: Vascular enhancement as shown by MR imaging may herald ischemic brain infarction and could persist over several weeks in areas that show collateral flow after infarction has occurred.