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In Vivo Identification of Complicated Upper Thoracic Aorta and Arch Vessel Plaque by MR Direct Thrombus Imaging in Patients Investigated for Cerebrovascular Disease

Richard Bitar1,2, Alan R. Moody1,2, General Leung2, Alexander Kiss3, David Gladstone4, Demetrios J. Sahlas4 and Robert Maggisano5

1 Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
2 Department of Medical Imaging, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., AG46, Toronto, Ontario, Canada M4N 3M5.
3 Institute for Clinical Evaluative Sciences (ICES), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
4 Department of Neurology and Regional Stroke Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
5 Division of Vascular Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.


Figure 1
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  		Fig. 1 —93-year-old man investigated for symptomatic disease (remote right infarct). Coronal MR direct thrombus imaging (MRDTI) shows complicated plaque in aortic arch (arrows).

 

Figure 2
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  		Fig. 2A —84-year-old woman investigated for right anterior circulation transient ischemic attacks using coronal MR direct thrombus imaging (MRDTI). Complicated atherosclerotic plaque is seen in left subclavian artery (arrow).

 

Figure 3
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  		Fig. 2B —84-year-old woman investigated for right anterior circulation transient ischemic attacks using coronal MR direct thrombus imaging (MRDTI). Contrast-enhanced MR angiography (CEMRA) shows total occlusion at origin of left subclavian artery (arrow).

 

Figure 4
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  		Fig. 3A —75-year-old man investigated for anterior circulation transient ischemic attack symptoms. Coronal MR direct thrombus imaging (MRDTI) showed complicated atherosclerotic plaque in this patient's brachiocephalic artery (arrow).

 

Figure 5
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  		Fig. 3B —75-year-old man investigated for anterior circulation transient ischemic attack symptoms. Axial reformat of coronal MRDTI through carotid arteries. Bilateral complicated carotid plaques are noted (arrows).

 

Figure 6
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  		Fig. 4 —Distribution of complicated carotid plaque and either upper thoracic aorta disease, arch vessel disease, or both. Relevant percentages are included.

 

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