对比分析高分辨MRI与MRA对穿支动脉供血区脑梗死责任血管的诊断价值

目的对比分析高分辨率MRI(HRMRI)与MRA对穿支动脉供血区脑梗死患者责任血管的诊断评估价值。方法对24例穿支动脉供血区脑梗死患者进行常规MRI、MRA检查,根据梗死区解剖学的血管支配参照MRA行相应责任血管的HRMRI检查。Fisher精确概率法比较HRMRI与MRA对穿支动脉的载体血管(大脑中动脉、椎动脉、基底动脉)狭窄的识别情况;Wilcoxon配对秩和检验比较HRMRI与MRA评估的穿支动脉载体血管的狭窄程度。分析患者颅内动脉斑块的特征、斑块对穿支血管开口及本身的影响。结果24例患者,梗死灶位于基底节区17例、脑干7例(其中3例小脑受累)。共检查24支穿支动脉载体血管包括大脑中动脉17支、椎动脉1支、基底动脉6支。HRMRI判断责任载体血管狭窄的检出率(91.67%,22/24)明显高于MRA(62.5%,15/24)(P0.05)。对狭窄程度的判断HRMRI比MRA更准确(Z=91,P0.05)。HRMRI示23支载体血管有斑块形成,1支内膜增厚。8例HRMRI显示斑块覆盖或累及穿支血动脉开口;5例HRMRI示穿支动脉本身狭窄。而MRA不能显示穿支动脉及开口情况(P0.05)。结论 HRMRI对穿支动脉的载体血管有无狭窄及狭窄程度的判断优于MRA,还能显示穿支动脉本身管径和开口受累情况,为穿支动脉供血区脑梗死的发生机制提供更多的循证医学的依据。     

高分辨磁共振成像在内囊纹状体梗死患者的诊断价值

目的探讨高分辨磁共振成像(high resolution magnetic resonance imaging,HRMRI)对内囊纹状体梗死(striatocapsular infarction)的诊断价值。方法收集经磁共振证实的内囊纹状体梗死患者26例,分别行磁共振血管成像(magnetic resonance angiography,MRA)和HRMRI检查,利用HRMRI分析动脉粥样硬化斑块在大脑中动脉(middle cerebral artery,MCA)的分布位置,比较MRA与HRMRI识别MCA狭窄能力的差异。结果MRA检查显示MCA狭窄者10例(38.5%),HRMRI显示MCA狭窄者20例(76.9%)(χ~2=4.875,P=0.027)。HRMRI显示MCA狭窄的20例患者,其粥样硬化斑块位于血管管壁的下侧12例(60.0%)、腹侧6例(30.0%)、上侧2例(10.0%)、背侧0例(χ~2=7.600,P=0.022)。结论HRMRI在诊断MCA狭窄方面可信度较高;内囊纹状体梗死患者MCA粥样硬化斑块大多分布在穿支动脉开口对侧。     

高分辨磁共振成像在脑桥旁正中梗死患者中的诊断价值

目的 探讨高分辨磁共振成像(high resolution magnetic resonance imaging, HRMRI)在脑桥旁正中梗死(paramedian pontine infarction,PPI)患者中的诊断价值。方法 连续收集经磁共振证实的PPI患者32例,全部行磁共振血管成像(magnetic resonance angiography, MRA)和HRMRI检查,利用HRMRI分析动脉粥样硬化斑块在基底动脉(basilar artery, BA)的分布位置,比较MRA与HRMRI识别BA狭窄能力的差异。结果 MRA检查显示BA狭窄者11例(34.4%),HRMRI 显示BA狭窄者27例(84.4%)(P<0.01)。HRMRI显示BA狭窄的27例患者,其粥样硬化斑块位于梗死病灶同侧25例(92.6%)、对侧2例(7.4%)。结论 HRMRI在诊断BA狭窄方面可信度较高; 脑桥旁正中梗死患者BA粥样硬化斑块大多分布在梗死病灶同侧     

3.0T HRMRI头颈联合技术对症状性MCA狭窄患者颅内外动脉管壁病变的诊断价值

目的探讨症状性大脑中动脉(MCA)狭窄患者颅内外动脉管壁病变特点和3.0T高分辨磁共振成像(High-resolution magnetic resonance imaging,HRMRI)头颈联合技术的临床应用价值。方法 11例症状性MCA狭窄患者接受三维增强磁共振血管成像(3D ce-MRA)与3.0T HRMRI的T_1w-db SPACE平扫和T_1w-db SPACE增强扫描,并结合头颈部颅内外动脉管壁不间断联合扫描新技术。结果共扫描11例患者的88处颅内外动脉管壁,其结果发现:1例中枢神经系统血管炎,其左侧MCA及左侧颈内动脉(ICA)颅内段在T_1w-db SPACE像上表现为管壁环形增厚及环形强化;1例颅内动脉夹层,其左侧MCA在T_1w-db SPACE像呈长条状高信号,相应高信号在T_2wdb SPACE像上为等低信号;9例动脉粥样硬化患者均合并双侧MCA粥样硬化斑块,表现为管壁偏心性增厚,其中8例(88.9%)合并颅内外动脉粥样硬化,增强扫描见6例(67%)颅内外动脉粥样硬化斑块均有强化。比较3D ceMRA与HRMRI结果发现,88处血管中,23处血管的3D ce-MRA与HRMRI均未见明显异常;31处血管的3D ceMRA与HRMRI显示相对一致,即3D ce-MRA显示狭窄或者扩张、HRMRI显示管壁呈不同程度的增厚或附壁斑块;34处血管的3D ce-MRA与HRMRI显示欠一致,其中,26处血管的3D ce-MRA大致正常而HRMRI显示管壁增厚(5处)或斑块(21处),8处血管的3D ce-MRA显示轻度狭窄(6处)或扩张(2处)而HRMRI显示管腔外径及管壁均大致正常。判断颅内外动脉异常的组间一致性可(3D ce-MRA、HRMRI的Kappa值分别为0.67、0.69,P0.001)。结论 3.0T HRMRI头颈联合技术可清晰地显示颅内外动脉的管壁结构和病变特点,识别3D ce-MRA未能发现的狭窄,甄别动脉狭窄的病因,对颅内外动脉管壁病变的诊断具有较高的临床应用价值。     

高分辨率磁共振斑块成像与DSA评估症状性大脑中动脉狭窄的比较

目的探讨高分辨率磁共振(HRMRI)斑块成像评估症状性大脑中动脉狭窄程度的价值。方法对25例DSA确诊的单侧(MCA)症状性狭窄≥50%患者行HRMRI检查,观察HRMRI上MCA狭窄处的管腔和管壁特点,计算狭窄率并与DSA上的狭窄率进行比较。结果 16例MCA在HRMRI上均发现管腔狭窄,14例管壁增厚,其中13例为偏心性增厚;12例偏心性强化,1例无强化;1例为向心性增厚并强化;2例管壁大致正常,外径缩窄。在DSA和HRMRI上测量的狭窄率之差为:10%±5%,HRMRI狭窄率(76%±14%)普遍高于DSA狭窄率(64%±11%)(t=8.702,P<0.05)。结论 HRMRI能清晰的显示症状性MCA狭窄的管腔和管壁特点,对于MCA狭窄的诊断有一定参考价值。     

高分辨率磁共振检测颅内动脉粥样硬化易损斑块与中老年复发脑梗死的关系

目的通过高分辨率磁共振成像(HRMRI)技术分析颅内动脉粥样硬化(ICAD)斑块性质,初步探讨ICAD斑块与复发脑梗死(RCI)的关系。方法选取2016年1月至2017年11月在本院住院的由头颈MRA或CTA证实存在大脑中动脉或基底动脉中重度狭窄的脑梗死患者61例,其中男性36例,女性25例,年龄45～73岁,平均年龄(61.7±6.1)岁。所有患者分为初发脑梗死(PCI)患者28例和RCI患者33例,所有脑梗死患者均行HRMRI检查,根据不同信号特点分析ICAD斑块性质,区分不稳定斑块和稳定斑块。观察两组颅内不稳定斑块情况,Logistic回归分析颅内不稳定斑块与RCI的相关性。结果(1) RCI组和PCI组之间基线临床特征比较,RCI组年龄、2型糖尿病、高血压病比例显著高于PCI组,差异有统计学意义(P0.05),其余差异无统计学意义;(2) RCI组不稳定斑块比例明显高于PCI组,差异有统计学意义(P0.05);(3) Logistic回归分析显示,除了年龄、2型糖尿病外,颅内不稳定斑块是RCI的独立危险因素(OR为18.088,95%CI为2.587～126.450,P值为0.004)。结论颅内易损斑块与RCI密切相关,重视中老年脑梗死患者颅内不稳定斑块的检测,有助于预测RCI的风险,为二级预防提供临床依据。     

高分辨率磁共振评价症状性大脑中动脉粥样硬化斑块与脑梗死发生的关系

目的应用高分辨率磁共振成像(HRMRI)检测症状性大脑中动脉(MCA)狭窄处斑块,初步探讨斑块稳定性与脑梗死发生的关系。方法收集症状性大脑中动脉M1段狭窄的短暂性脑缺血发作患者76例。收集一般临床资料,对MCA-M1狭窄段进行HRMRI血管壁检查,分析狭窄部位斑块信号特点,评估斑块的稳定性。根据HRMRI评估的斑块性质,将其分为不稳定斑块组(46例)和稳定斑块组(30例),其中将不稳定斑块组分为斑块内出血组(13例)、强化斑块组(17例)和混合斑块组(16例)。随访18个月,记录并比较两组患者首次就诊至发生目标MCA供血区发生脑梗死的时间及比例。结果①不稳定斑块组发生MCA区脑梗死的比例是25/46,稳定斑块组是9/30,差异有统计学意义(P <0.05);②不稳定斑块组发生MCA区脑梗死的时间中位数是17.0(10.5,18.0)个月,明显短于稳定斑块组中位数18(16.3,18.0)个月,差异有统计学意义(P <0.05);③不稳定斑块分型的三组间发生MCA区脑梗死的比例和时间的比较均无统计学差异(P> 0.05)。结论应用HRMRI可评估大脑中动脉斑块的稳定性,从而预测脑卒中的风险,为临床提供更多的指导信息。     

以皮质蛛网膜下腔出血为首发症状的脑梗死2例报道及文献复习

目的提高对皮质蛛网膜下腔出血(cSAH)为首发症状的大脑中动脉(MCA)狭窄致急性脑梗死的认识。方法报道2例cSAH患者的临床表现、CT和MRI所见、治疗和预后,并复习相关文献进行讨论。结果 2例患者均有高血压病、糖尿病或冠心病史,突发肢体瘫痪,无头痛。头颅CT显示偏瘫对侧大脑皮质沟高密度影,进一步MRI检查提示CT高密度影为SWI低信号出血灶;同时MRA显示偏瘫对侧MCA M1段局限性狭窄,并于同侧放射冠见新发梗死灶。结论 MCA狭窄可以引起cSAH的临床放射综合征,同时伴有新发脑梗死。在cSAH诊断流程中,应该包括应用SWI和MRA检查。     

烟雾病的MRI和MRA诊断

目的探讨磁共振成像(MRI)和磁共振动脉成像(MRA)对烟雾病的诊断价值。方法回顾性分析22例烟雾病患者的临床和影像资料,全部行MRI和MRA(3D-TOF法)检查,其中10例进行了DSA检查。结果MRI上脑实质内均出现异常信号,其中脑梗死8例,脑出血7例,脑萎缩3例,脑软化4例,8例患者在基底节区有血管流空现象。MRA均良好显示病变血管狭窄或闭塞,呈多支受累,与DSA所见相似。结论MRI结合MRA是诊断烟雾病的无创和有效手段。     

桥脑梗死高分辨率磁共振基底动脉管壁成像研究

目的应用高分辨率磁共振(HR-MRI)管壁成像技术研究基底动脉粥样硬化在不同类型桥脑梗死中的作用。方法收集长海医院收治的急性孤立性桥脑梗死行3. 0T HR-MRI基底动脉管壁成像检查患者,桥脑梗死分为桥脑旁中央梗死(PPI)和深部小梗死(SDPI)。所有患者均行3D-TOF MRA和HR-MRI管壁T_1WI、T_2WI和T_1WI增强序列扫描,对比研究PPI和SDPI患者基底动脉是否存在斑块及斑块特征。结果 55例急性桥脑梗死患者纳入本研究,其中PPI组37例,SDPI组18例。3D TOF MRA显示PPI组和SDPI组基底动脉狭窄50%以上分别为21例(58. 8%)和7例(38. 9%),两组无统计学差异(P=0. 214)。PPI组16例基底动脉狭窄小于50%,其中14例(87. 5%) HR-MRI检测出基底动脉斑块形成,为分支动脉粥样硬化病(BAD),明显高于SDPI组(27. 3%),两组差异具有统计学意义(P=0. 001),BAD斑块强化分别占PPI组和SDPI组中35. 1%和5. 6%,两组比较具有统计学意义(P=0. 018)。结论 HR-MRI基底动脉管壁成像研究显示动脉粥样硬化是PPI和SDPI的常见原因,BAD不稳定斑块常见于PPI,而SDPI中少见。     

大脑中动脉狭窄脑深部小梗死发病机制的研究

目的 研究大脑中动脉粥样硬化性狭窄患者脑深部小梗死的发生频率和发病机制。方法86例发病时间〈1周的急件脑梗死患者，行经颅多普勒超声、彩色超声、磁共振血管造影及功能磁共振成像等检查方法被明确诊断为症状性大脑中动脉粥样硬化性狭窄，并排除颈内动脉病变、心源性栓塞以及非动脉粥样硬化性狭窄。利用磁共振扩散加权成像观察梗死灶的形态学表现及特点，分析其发病机制。结果37例（43．02％）症状性大脑中动脉粥样硬化性狭窄患者存在深部小梗死，多呈孤立性单发病灶。其中内囊纹状体梗死及巨大腔隙者18例（20．93％），梗死灶体积多超过两个层面，少数病灶呈多灶分布的特点；直径较小的腔隙性梗死19例（22．09％），梗死灶体积〈15mm，多位于一个层面内。伴有大脑中动脉粥样硬化性狭窄的深部小梗死的患者，病情多不稳定，预后较差。所有脑深部小梗死患者均伴有大脑中动脉主干支狭窄，且梗死灶体积与大脑中动脉粥样硬化性狭窄程度有关，内囊纹状体梗死多见于大脑中动脉重度狭窄者。结论约50％大脑中动脉粥样硬化性狭窄患者存在脑深部小梗死，其发病机制与大脑中动脉粥样硬化斑块或斑块残端血栓蔓延堵塞深穿支动脉入口有关。对此类患者的治疗不同于经典的腔隙性脑梗死。     

高清磁共振研究基底动脉粥样硬化狭窄重构模式在脑桥旁正中梗死中的应用

目的 应用3.0T高分辨磁共振成像（high resolution magnetic resonance imaging,HRMRI）探讨脑桥旁 正中梗死（paramedian pontine infarction,PPI）患者基底动脉管壁特征及重构模式。 方法 连续入组孤立脑桥旁正中梗死患者30例,行头颅磁共振平扫及头颅磁共振血管成像 （magnetic resonance angiography,MRA）检查,并用3.0T HRMRI对基底动脉检查,测量管壁特征并计 算重构指数（remodeling index,RI）（最窄处血管面积/参考处血管面积）。RI≤0.95为阴性重构,RI 在 0.95～1.05之间为无重构,RI≥1.05为阳性重构,比较阴性重构和阳性重构的斑块面积、斑块负荷等 特点。 结果 30例患者在MRA上共发现9例有基底动脉狭窄,21例显示管腔正常,而在HRMRI可发现25例患 者有基底动脉粥样硬化性斑块,并可见斑块位于脑桥旁正中梗死责任血管的穿支动脉口。对HRMRI上 发现有动脉粥样斑块的25例患者计算RI,其中阴性重构8例,无重构6例,阳性重构11例,比较两组数 据,阳性重构组的斑块面积（8.17±4.7）mm2及斑块负荷（29.07±15.03）%均大于阴性重构组的斑块 面积（1.08±1.89）mm2及斑块负荷（3.96±6.76）%,差异具有显著性。 结论 HRMRI有助于缺血性卒中的病因学分型并评估病变的RI。脑桥旁正中梗死患者基底动脉阴性 重构与阳性重构同样常见,阳性重构常合并较大的动脉粥样硬化斑块,且斑块面积及斑块负荷均大 于阴性重构。     

Middle cerebral artery plaque imaging using 3-Tesla high-resolution MRI

Diagnosis of deep subcortical infarcts based on atherosclerosis of the middle cerebral artery (MCA) is important because this type of infarct is usually more aggressive than typical lacunar infarcts. However, current imaging techniques are of limited utility in the diagnosis of MCA plaques. Here, we report the use of 3-Tesla (3T) high-resolution moderate T(2)-weighted imaging (HRT(2)WI) to detect MCA plaques in three patients with acute MCA perforator territory infarcts. MCA plaques were seen with HRT(2)WI in a patient with MCA stenosis, which was observed by magnetic resonance angiography (MRA). Of the two patients without MCA stenosis (also confirmed by MRA), one had thin MCA plaques and the other had normal walls based on HRT(2)WI. Progression of symptoms occurred in the patients with plaques. We conclude that 3T HRT(2)WI can identify plaque on MCA walls and has the potential to identify patients at risk for stroke progression or recurrence.     

大脑中动脉粥样硬化的狭窄度与卒中机制——一项高分辨磁共振研究

目的本研究旨在探索大脑中脉(middle cerebral artery,MCA)狭窄率与MCA斑块形态学及梗死类型的相关性,并探索不同狭窄率患者卒中的发生机制。方法连续收集2009-2014年于北京协和医院就诊的2周内发生MCA供血区缺血性卒中并进行高分辨磁共振(high-resolution magnetic resonance imaging,HRMRI)扫描的患者。纳入MCA M1段存在斑块的患者,排除心源性、颅外大动脉粥样硬化及其他病因的卒中患者。在弥散加权成像(diffusion weighted imaging,DWI)上将梗死类型分为穿支、皮层、分水岭和混合型梗死,并测量梗死体积。在矢状位HRMRI上测量MCA M1段狭窄率,并收集斑块位置、长度、厚度、信号和斑块连续性等形态学指标。将狭窄率50%的患者分入重度狭窄组,将狭窄率≤50%的患者归入轻度狭窄组。结果研究共纳入102例患者,其中重度狭窄组39例,轻度狭窄组63例。重度狭窄组患者卒中,穿支梗死14例(35.9%),皮层梗死9例(23.1%),分水岭梗死4例(10.3%),混合型梗死12例(30.8%);轻度狭窄组患者中,穿支梗死44例(69.8%),皮层梗死8例(12.7%),分水岭梗死3例(5.8%),混合型梗死8例(12.7%),两组构成类型比较,差异有显著性(P=0.014)。与轻度狭窄组比较,重度狭窄组患者斑块更长(P0.001)、更厚(P0.001)、更多混合信号斑块(P0.001)。斑块厚度(P0.001,OR 87.792,95%CI 13.120~587.453)和斑块混合信号(P=0.007,OR 7.358,95%CI 1.725~31.382)是MCA狭窄率50%的独立预测因子。重度狭窄组中,梗死体积与斑块表面不连续(P=0.004)相关。轻度狭窄组中,梗死类型与斑块表面不连续(P=0.002)及斑块厚度(P=0.032)相关。且斑块表面不连续是发生栓塞性梗死的独立预测因子(P=0.003,OR 5.778,95%CI 1.788~18.672)。结论 MCA狭窄率50%和≤50%的患者具有不同的卒中分型比例和斑块形态学;狭窄率≤50%的斑块表面不连续是栓塞性梗死独立预测因子,提示轻度狭窄MCA斑块破裂可能是引起栓塞性病灶的机制。     

急性脑梗死散在和单一弥散加权成像病损与其供血动脉狭窄的关系

目的 探讨急性脑梗死弥散加权磁共振成像(DWI)上大脑中动脉(MCA)供血区散在性或单一性缺血性病损与其脑供血动脉狭窄或闭塞的关系.方法 回顾性分析73例连续积累的DWI显示一侧MCA供血区脑梗死的病例,入组病例均排除心源性栓塞性脑梗死,所有患者均在发病24 h内进行MRI和MRA等检查,7例患者并进行DSA.采用DWI急性缺血性病损分类方法 分为散在病损组和单一病损组,比较两组的病灶同侧MCA、颈内动脉(ICA)颅内段和颅外段狭窄或闭塞的发生率.结果 散在病损组42例,单一病损组31例.在病损同侧ICA颅外段和MCA闭塞或重度狭窄方面两组差异有统计学意义(28.6%与0,x2=10.6,P=0.001).在病损同侧ICA颅内段并MCA轻中度狭窄方面,两组间差异具有统计学意义(31.0%与9.7%,x2=4.717,P=0.03).散在病损与MCA和(或)ICA严重或多发狭窄呈正相关(OR值为13.7,95%CI:3.6～52.5).在MRA或DSA未发现颅内外大血管狭窄方面,两组间差异具有统计学意义(11.9%与32.3%,x2=4.526,P=0.033).散在病损组与无明显血管狭窄呈负相关(OR值为0.284,95%CI:0.09～0.94).结论 (1)脑梗死急性期DWI显示的MCA区散在性病损患者,MCA和ICA狭窄、甚至闭塞的可能性较大,以ICA颅外段闭塞较为常见;(2)DWI显示单一病损时提示脑供血动脉狭窄程度较轻,范围较局限,小血管病变的可能性相对较高,很少为严重的ICA颅外段狭窄或闭塞.

Abstract：

Objective To investigate the relationship between scattered or single lesion of acute cerebral infarction in middle cerebral artery territory on diffusion-weighted imaging (DWI) and stenosis of middle cerebral artery (MCA) or internal carotid artery (ICA). Methods With exclusion of cardioembolism, 73 consecutive patients with acute cerebral infarction of the unilateral MCA territory on DWI were analyzed. All patients got magnetic resonance imaging (MRI) and angiography (MRA) within 24 hours after onset, and 7 patients also had digital subtraction angiography (DSA). The patients were classified into single lesion group or scattered lesions group according to the DWI findings. The incidence of stenosis or occlusion of ipsolateral MCA, intracranial and extracranial ICA were compared between the two groups. Results 42 patients had scattered lesions and 31 patients had single lesion. The scattered-lesions group had a high incidence of ipsilateral extracranial ICA or MCA occlusion or severe stenosis ( 25.6%versus 0, x2 = 10.6, P = 0.001 ) and a high incidence of ipsilateral intracranial ICA or MCA moderate or mild stenosis (31.0% versus 9.7% ,x2 =4.717, P =0.03 ). A positive correlation was found between the scattered lesions and severe or multifocal stenosis of ipsilateral ICA and MCA ( OR: 13.7, 95% CI: 3.6 to 52.5). There was a low incidence of absence of extra- and intracranial stenosis on MRA or DSA in the scattered-lesions group ( 11.9% versus 32.3%, x2= 4.526, P = 0.033 ). A negative correlation was found between the scattered lesions and absence of large-artery stenosis ( OR: 0.284, 95% CI: 0.09 to 0.94).Conclusions ( 1 ) Patients with acute cerebral infarction and scattered lesions on DWI were more likely to suffer from stenosis or occlusion of ICA or MCA, especially over the extracranial ICA. (2) Patients with single lesion were less likely to have severe or multiple stenosis of MCA and ICA, indicating the relevance of small-vessel pathogenesis.     

Wall characteristics and mechanisms of ischaemic stroke in patients with atherosclerotic middle cerebral artery stenosis: a high-resolution MRI study

Objective:: To evaluate the characteristics of atherosclerotic middle cerebral artery (MCA) stenosis by high-resolution magnetic resonance imaging (HR-MRI) and determine the relationship between wall characteristics and infarction patterns.

Methods:: Thirty-six patients with acute ischaemic stroke due to MCA stenosis underwent diffusion-weighted magnetic resonance imaging (DWI) and HR MRI. Wall characteristics of MCA, including irregular surface, superior location, T2-hyperintense of plaques and positive remodelling (PR), were analysed. Characteristics of acute infarct on DWI were categorised according to the number (single or multiple infarcts) and the pattern of cerebral infarcts (cortical, border zone or perforating artery territory infarcts). The relationship between wall characteristics and infarction patterns was evaluated.

Results:: PR was observed in 20 patients, irregular surface plaque in 18 patients, superior location of plaques in 14 patients and T2-hyperintense foci in 13 patients. Seventeen patients had multiple acute cerebral infarcts and 13 showed single acute cerebral infarcts. Border zone infarcts were the most common (76.5%) among multiple acute infarcts. Penetrating artery infarcts (PAI) accounted for 76.9% of all single infarcts. Multiple infarcts were more frequently observed in patients with PR (P = 0.007) or plaque surface irregularity (P = 0.035). Single infarcts, especially PAI, were more prevalent in patients with superior plaque (P = 0.030). No statistically significant differences were observed between multiple and single infarcts in patients with T2-hyperintense lesions (P?=?0.638).

Conclusions:: PR or irregular surface plaques were associated with artery-to-artery embolism. Superior location of plaques was associated with PAI. HR-MRI provides insights into intracranial atherosclerosis in vivo, predictive of infarction patterns.