Neurosonology

Etiology of Intracranial Arterial Stenosis: Are Transcranial Color-Coded Duplex Ultrasound and 3T Black Blood MR Imaging Complementary?

Perren et al. compared in this study the diagnostic sensitivity of transcranial color-coded duplex (TCCD) sonography and the recently developed 3D high-resolution black blood MR sequence in revealing the etiology of intracranial arterial stenosis.

Perren F, Vargas MI, Kargiotis O. J Neuroimaging. 2015 Nov 24. doi: 10.1111/jon.12315

http://www.ncbi.nlm.nih.gov/pubmed/27040482

Perren et al. compared in this study the diagnostic sensitivity of transcranial color-coded duplex (TCCD) sonography and the recently developed 3D high-resolution black blood MR sequence in revealing the etiology of intracranial arterial stenosis.

In this study, the authors evaluated retrospectively 20 patients after acute ischemic stroke who were diagnosed with intracranial stenosis. In all cases a repetitive TCCD and a 3D MR T1 FAT SAT (black blood) sequence at 3T (TR/TE 350/20 ms, FOV 160×182×120 mm, 0.4×0.4×0.4 size of pixel, 300 slices, Fat Sat spair, acquisition time 6 minutes 14) were performed.

The authors based the etiological diagnosis on the morphological aspect of the arterial wall (black blood T1 FAT SAT sequence) and on the hemodynamic aspect (TCCD).

According to the results of this study, eleven patients had diffuse intracranial arterial disease and nine had involvement of a single intracranial artery. Etiology of intracranial arterial stenosis included: atheromatosis, thrombosis, vasculitis and reversible vasoconstriction syndrome. Interestingly, there was 80% agreement (sign test P = 0.0059) between these two methods.

The main take home message of this study is, the complementary role of these two imaging techniques might be promising for the differentiation of arteriosclerotic changes from stenosis of another origin.