Intracranial Atherosclerotic Plaque Evaluation Using Three Dimensional Isotropic Multi-Contrast MRI

Dongxiang Xu¹, Jinnan Wang², William S. Kerwin¹, Chun Yuan¹

Intracranial atherosclerotic disease (IAD) is one of the most common causes of stroke worldwide. Clinically, IAD is usually diagnosed with angiography based imaging methods to detect luminal narrowing. However, autopsy studies2 show that approximately 40% of IAD does not present with any luminal stenosis but rather only outer wall remodeling, an indicator of progression of plaque burden. To overcome this underestimation of stroke risk, analysis of the intracranial vessel wall (IVW) is crucial. Recent developments in 3D isotropic MR imaging techniques provide sufficient wall contrast in in vivo MR IVW images. Due to the tortuous topology of intracranial vessels, cross sectional images reformatted based on the geometry of the arteries are desirable. However, no approaches have thus far been proposed to effectively analyze IVW images, and most current IVW analysis is still limited to arterial sections that are approximately straight. In this study, we proposed a new approach that allows effective evaluation of atherosclerotic plaques at all locations along intracranial arteries by using 3D isotropic multi-contrast MRI.