J Stroke.  2015 Sep;17(3):320-326. 10.5853/jos.2015.17.3.320.

Quantitative Magnetic Resonance Angiography in Internal Carotid Artery Occlusion with Primary Collateral Pathway

• Bae YJ
• Jung C
• Kim JH
• Choi BS
• Kim E

• KMID: 2381495
• DOI: http://doi.org/10.5853/jos.2015.17.3.320

Abstract

BACKGROUND AND PURPOSE
Quantitative magnetic resonance angiography (Q-MRA) enables direct measurement of volume flow rate (VFR) of intracranial arteries. We aimed to evaluate the collateral flows in internal carotid artery (ICA) occlusion with primary collateral pathway via circle of Willis using Q-MRA, and to compare them between patients who recently developed ipsilateral symptomatic ischemia and those who did not.
METHODS
Between 2012 and 2014, 505 patients underwent Q-MRA in our institution. Among these, 33 patients who had unilateral ICA occlusion with primary collateral pathway were identified, and grouped into asymptomatic patients, stable patients with chronic infarction, and symptomatic patients with acute/subacute infarction. Mean VFR (mVFR) in intracranial arteries was measured and compared between the patients' groups. Kruskal-Wallis test was used for statistical analysis.
RESULTS
Six patients were asymptomatic, fifteen with chronic infarction were stable, and twelve with acute/subacute infarction were symptomatic. The mVFR of ipsilateral middle cerebral artery in symptomatic patients was significantly lower than those in stable or asymptomatic patients (73.7+/-45.6 mL/min vs. 119.9+/-36.1 mL/min vs. 121.8+/-42.0 mL/min; P = 0.04). Total sum of the mVFR of ipsilateral anterior, middle, and posterior cerebral arteries was significantly lower in symptomatic patients than those in other groups (229.3 +/- 51.3 mL/min vs. 282.0+/-68.6 mL/min vs. 314.0+/-44.4 mL/min; P = 0.02).
CONCLUSIONS
Q-MRA could be helpful to demonstrate the difference in the degree of primary collateral flow in ICA occlusion between the patients with recent symptomatic ischemia and those without.

Keyword

Magnetic resonance angiography; Carotid artery, internal; Collateral circulation

MeSH Terms

Arteries
Carotid Artery, Internal*
Circle of Willis
Collateral Circulation
Humans
Infarction
Ischemia
Magnetic Resonance Angiography*
Middle Cerebral Artery
Posterior Cerebral Artery