Analysis of the occlusion site and length of intracranial atherosclerotic large vessel occlusion based on high-resolution MRI
CAO Chen
GUO Yu
XIA Shuang
Abstract：Objective To analyze the occlusion site and length of intracranial atherosclerotic large vessel occlusion using high-resolution MRI(HR-MRI)and T2*WI,and to evaluate its diagnostic consistency with digital subtraction angiography(DSA).Methods A total of 62 patients(50 males and 12 females,mean age 58.3±12.1 years)with symptomatic intracranial atherosclerotic large vessel occlusion who underwent endovascular recanalization from June 2020 to March 2022 were retrospectively collected.Two physicians analyzed the occlusion site(distal internal carotid artery,proximal M1 segment of the middle cerebral artery,and distal M1 segment of the middle cerebral artery)and measured the occlusion length on HR-MRI and T2*WI.One physician reassessed the same images 14 days after the first reading.Kappa test and intra-class correlation coefficient(ICC)were used to analyze intra-observer and inter-observer consistency.The gold standard was the occlusion site and length diagnosed by DSA during endovascular recanalization.The diagnostic consistencies of HR-MRI and T2*WI with DSA were analyzed using kappa test,ICC,and Bland-Altman analysis.Results HR-MRI demonstrated excellent intra-and inter-observer consistency in the site and length of occlusion(κ or ICC≥0.95).In T2*WI,intra-observer consistency for analyzing the occlusion site(κ=0.91)and length(ICC=0.93)were excellent,while inter-observer consistency were good(κ=0.61;ICC=0.76).The diagnostic consistencies of HR-MRI with DSA for occlusion site(κ=0.97)and occlusion length(ICC=0.83)were excellent,superior to the diagnostic consistencies of T2*WI with DSA(occlusion site:κ=0.42;occlusion length:ICC=0.34).Bland-Altman analysis also indicated that HR-MRI was superior to T2*WI in diagnosing occlusion length,consistent with DSA.Conclusion HR-MRI is superior to T2*WI in terms of diagnostic consistency for evaluating occlusion site and length with DSA,making it a powerful tool for preoperative screening of endovascular treatment.
Keywords：High-resolution magnetic resonance imagingDigital subtraction angiographyArteriosclerosisOcclusionIschemic stroke
Publication Date：2024-03-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 143-147 )