Intracranial atherosclerotic disease (ICAD) is one of the most common causes of ischemic stroke worldwide. Despite intensive medical management, which is the current standard of care, the rate of recurrent stroke is 13% in the first year and as high as 35% in certain populations by 2 years. Initial and follow-up evaluations of these patients rely exclusively on assessments of clinical risk factors and, in some circumstances, the degree of luminal stenosis on imaging, which may overlook subtle non-luminal changes within ICAD lesions. In the present work, we sought to assess the feasibility of quantitatively monitoring regression or progression of intracranial atherosclerotic plaques using 3D VWI.
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