Middle Cerebral Artery Stroke Lesion Pattern Classification After Thrombolysis Based on Diffusion-Weighted Imaging & MR-Angiography

Alex Foerster¹, Achim Gass¹, Rolf Kern¹, Martin Griebe¹, Angelika Alonso¹, Michael G. Hennerici¹, Kristina Szabo¹

We analyzed stroke morphology on MRI in patients with stroke in the middle cerebral artery territory (MCAT) who received i.v. thrombolysis. Lesion patterns were classified by identifying index lesions in the MCAT and concomitant lesions in the MCAT, other vascular territories or borderzones on DWI and middle cerebral artery (MCA) pathology on MRA. All predefined DWI and MRA patterns occurred in the population. A typical pattern associated with successful recanalisation was small embolic lesions and a normal/strong MCA signal. The classification is based on routinely used MRI sequences and may be useful for a precise stroke pattern description in general.