High-resolution MR can accurately evaluate the mechanisms and extent of cerebral vascular occlusions

CHEN Xiang; WANG Wei

doi:10.12122/j.issn.1674-4500.2025.06.15

Abstract：Objective To explore the value of high resolution MR Vascular wall imaging in the mechanisms and extent of cerebral vascular occlusions.Methods From May 2016 to January 2025,50 patients diagnosed with cerebral infarction in our hospital,including 56 occluded cerebral vessels identified by time-of-flight magnetic resonance angiography(TOF MRA)underwent high-resolution vessel wall imaging(HRVWI)to analyze the pathological mechanisms and measure the occlusion length.The occlusion lengths were scored 1,2,or 3 points based on their extent from shortest to longest.All patients underwent digital subtraction angiography(DSA)within one week after MRI examination,with recanalization therapy performed on 23 occluded vessels.Differences in occlusion length assessment between HRVWI and TOF MRA were compared.The Kappa consistency test was used to evaluate the agreement between these two imaging modalities and DSA.Results HRVWI clearly revealed the causes and lengths of vascular occlusions.The occlusion mechanisms included thrombosis(20 cases),atherosclerotic plaque(17 cases),thrombosis superimposed on atherosclerosis(9 cases),moyamoya disease(4 cases),vasculitis(1 case),dissection(3 cases),fusiform aneurysm with mural thrombosis(1 case),and restenosis after stenting for dissection(1 case).The occlusion length scores assessed by HRVWI and TOF MRA were 1.34±0.55 and 1.64±0.67,respectively,with a statistically significant difference(P<0.0001).The Kappa values for agreement between HRVWI/TOF MRA and DSA in assessing occlusion length were 0.964 and 0.559,respectively.The Kappa value for agreement between HRVWI and DSA in determining occlusion mechanisms was 0.975.Conclusion High resolution MR can accurately evaluate the mechanisms and extent of cerebrovascular occlusions.