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Angioplasty for Symptomatic Middle Cerebral Artery Stenosis and a Perioperative Evaluation Using High-Resolution Magnetic Resonance Imaging at 3 T

MingChao Shi, MD; ShouChun Wang, PhD; Hong-Wei Zhou, PhD; XunCan Liu, MD; JiaChun Feng, PhD; Jiang Wu, PhD
Arch Neurol. 2011;68(12):1610-1611. doi:10.1001/archneurol.2011.901.
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A 46-year-old man with a history of smoking and diabetes mellitus presented with recurrent hemiparesis. Catheter angiography revealed stenosis in the right middle cerebral artery (MCA) (Figure 1). High-resolution magnetic resonance imaging (MRI) with a 3-T scanner revealed an eccentric plaque in the right MCA (Figure 2). This patient underwent angioplasty for his MCA stenosis. Surprisingly, despite prolonged dilatation with high pressures, the stenosis did not open completely after angioplasty. A follow-up high-resolution MRI scan revealed that the plaque was still there. As shown in previous reports,13 a high-resolution MRI scan can clearly show the wall structure of the MCA. To our knowledge, this is the first documentation of the use of high-resolution MRI before and after angioplasty of the intracranial vessel.

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Figure 1. Catheter angiographic image revealing stenosis in the right middle cerebral artery (arrow).

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Figure 2. Axial (T1-weighted [T1W], proton density–weighted [PDW], contrast-enhanced T1-weighted [CE-T1W], and T2-weighted [T2W]) images revealing an eccentric atherosclerotic plaque (arrows) with inhomogeneous signal intensity.




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