London, United Kingdom 2013 2 Vascular imaging Microvascular imaging of symptomatic and asymptomatic MCA steno-occlusive patients using ultra-high-field 7T MRI : a preliminary comparative study Y. Lee1, C. Kang2, K. Kim3, C. Park4, H.Y. Kim5, Y. Min6, C.W. Park7, Y. Kim8, Z. Cho9 Department of Neurology, Gachon University Gil Medical Center, Gachon University, Incheon, SOUTH KOREA1, Neuroscience Research Institute, Gachon University, Incheon, SOUTH KOREA2, Department of Neurology, Gachon University Gil Medical Center, Gachon Uni-versity, Incheon, SOUTH KOREA3, Neuroscience Research Institute, Gachon University, Incheon, SOUTH KOREA4, Department of Neurology, Hanyang University, College of Medicine, Seoul, SOUTH KOREA5, Department of Neurology, Hallym University, College of Medicine, Seoul, SOUTH KOREA6, Neuroscience Research Institute, Gachon University, Incheon, SOUTH KO-REA7, Neuroscience Research Institute, Gachon University, Incheon, SOUTH KOREA8, Neurosci-ence Research Institute, Gachon University, Incheon, SOUTH KOREA9 Although patients with asymptomatic MCA steno-occlusion have a low rate of occurrence of stroke, the annual risk of stroke in patients with symptomatic MCA steno-occlusion has been reported to be 4–15%. It might be beneficial to explore how one could clearly visualize the MCA steno-occlusion and also identify the presence of collateral circulation using a noninvasive angiographic method. However, noninvasive and accurate MR angiographic technique for the detection of small vessels such as collateral vessels is not yet possible with conventionally available 1.5T or 3T MRI. The pur-pose of this study is to determine whether 7T MRA provides the improved depiction of microves-sels including lenticulostriate arteries and presumbed collaterals noninvasively and to compare the quantitative differences of microvessels around the MCA steno-occlusion of asymptomatic and symptomatic MCA steno-occlusive patients. All subjects were examined by conventional 3T MRA and ultra-high-field 7T MRA. The vascular densities of microvessels around the steno-occlusive MCA were measured using maximum intensity projection (MIP) and analyzed with a segmentation program. Ten patients (5 symptomatic, 5 asymptomatic) were enrolled. In asymptomatic MCA ste-no- occlusive group, numerous microvessels were visualized by 7T MRA, which were not visible by 3T MRA. The median value of vascular density observed by 7T MRA was significantly higher than that by 3T MRA in asymptomatic group (1.09 at 7T vs 0.84 at 3T, P=0.043), while there was no sig-nificant difference in symptomatic group (0.78 at 7T vs 0.49 at 3T, P=0. 715). There was no signifi-cant difference of selected area(mm2) in asymptomatic(202.66 at 7T vs 203.41 at 3T, P=0.138) and symptomatic groups(203.92 at 7T vs 202.43 at 3T, P=0.273). Ultra-high-field 7T MRA is capable of visualizing microvessels clearly compared with conventional 3T MRA. Noninvasive visualization of microvessels around steno-occlusive MCA would provide valuable information on the preservation of normal blood circulation from the ischemic insults and presence or development of microvessels might have a role of a risk factor for ischemic stroke. E-Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 257 1 Vascular imaging Topographic pattern of anteromedial pontine infarction is dependent on the basilar artery ath-erosclerotic plaque H.Y. Kim1, W.H. Jho2, Y.S. Kim3, Y.B. Lee4, H.S. Kwon5 Department of Neurology, College of Medicine, Hanyang University, Seoul, SOUTH KOREA1, Department of Neurology, College of Medicine, Hanyang University, Seoul, SOUTH KOREA2, Department of Neurology, College of Medicine, Hanyang University, Seoul, SOUTH KOREA3, De-partment of Neurology, Gachon University Gil Medical Center, Incheon, SOUTH KOREA4, Depart-ment of Neurology, College of Medicine, Hanyang University, Seoul, SOUTH KOREA5 Background and objective How frequently atheromatous branch occlusive disease, namely atherosclerotic plaque could be a cause of pontine infarction and what topographic pattern of pontine infarction is most correlated with the presence of plaque? In this study, using direct vessel wall imaging, HRMRI, we first ana-lyzed the incidence and frequency of basilar artery (BA) plaque in patients with pontine infarction. Then we investigated the relationship between the characteristics of BA plaque and topographic pat-tern of anteromedial pontine infarction. Methods Demographic and risk factors were investigated in all patients. Pontine infarctions were classified into anteromedial paramedian, anteromedial small deep, anterolateral, lateral, or posterior pontine infarction according to the arterial groups of pons (topographic pattern). Using HRMRI, BA plaques were divided into no, minimal, or apparent plaque and also categorized based on the involvement of the anterior, posterior, right lateral, or left lateral BA wall. The relationship of topographic pattern of pontine infarction with the presence and distribution of BA plaque was analyzed. Results Ninety-one patients with pontine infarction were included. BA plaque were detected in 70.33% on HRMRI. Patients with apparent plaque had higher frequency of diabetes mellitus, and lower high density lipoprotein. Paramedian pontine infarction had the BA plaque more frequently than small deep pontine infarction. Moreover, in patients with anteriomedial paramedian pontine infarction, BA plaque was more frequently located at the posterior wall (49.15%) as compared with the anterior (13.24%), right lateral (17.82%) and left lateral (21.58%) walls. Conclusions Obviously, anteromedial paramedian pontine infarctions were associated with BA plaque more fre-quently than other topographic types. It means that atheromatous branch occlusion would be the most causative mechanism of these types of pontine infarctions. E-Poster Terminal 5
Karger_ESC London_2013
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