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Comprehensive imaging analysis of intracranial atherosclerosis
Journal article   Open access   Peer reviewed

Comprehensive imaging analysis of intracranial atherosclerosis

Sebastian Sanchez, Mahmud Mossa-Basha, Vania Anagnostakou, David S Liebeskind and Edgar A Samaniego
Journal of neurointerventional surgery, Vol.17(3), pp.311-320
03/2025
DOI: 10.1136/jnis-2023-020622
PMID: 38719445
url
https://doi.org/10.1136/jnis-2023-020622View
Published (Version of record) Open Access

Abstract

Intracranial atherosclerotic disease (ICAD) involves the build-up of atherosclerotic plaques in cerebral arteries, significantly contributing to stroke worldwide. Diagnosing ICAD entails various techniques that measure arterial stenosis severity. Digital subtraction angiography, CT angiography, and magnetic resonance angiography are established methods for assessing stenosis. High-resolution MRI offers additional insights into plaque morphology including plaque burden, hemorrhage, remodeling, and contrast enhancement. These metrics and plaque traits help identify symptomatic plaques. Techniques like transcranial Doppler, CT perfusion, computational fluid dynamics, and quantitative MRA analyze blood flow restrictions due to ICAD. Intravascular ultrasound or optical coherence tomography have a very high spatial resolution and can assess the structure of the arterial wall and the plaque from the lumen of the target vascular territory. Positron emission tomography could further detect inflammation markers. This review aims to provide a comprehensive overview of the spectrum of current modalities for atherosclerotic plaque analysis and risk stratification.
Neuroimaging Stroke Atherosclerosis Magnetic Resonance Angiography Vessel Wall

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