Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of definite diagnosis of branch atheromatous disease confirmed by digital subtraction angiography-3 tesla magnetic resonance fusion imaging

Mikito Saito, M.D.1), Hiroyuki Kawano, M.D., Ph.D.1), Tatsuo Amano, M.D.1), Toshihiko Iwamoto, R.T.2) and Teruyuki Hirano, M.D., Ph.D.1)

1)Department of Stroke and Cerebrovascular Medicine, Kyorin University Faculty of Medicine
2)Department of Radiology, Kyorin University Hospital

We herein experienced one patient with typical branch atheromatous disease (BAD) type infarction. Digital subtraction angiography (DSA) and MRI fusion imaging revealed the relationship between atheromatous plaque and perforating branches. A 66-year-old male presented acute onset of dysarthria, the left side hemiparesis and sensory disturbance. Diffusion-weighted MR imaging (DWI) showed the right pontine acute infarction. We started to treat with dual antiplatelet therapy. However, the left-side hemiparesis was worsening on 4 days after admission. DWI showed infarct growth and plaque imaging revealed the atheromatous plaque in the basilar artery. We fused DSA and MRI T2 weighted imaging (DSA-MR fusion imaging) to illustrate the relationship between the atheromatous plaque and the perforating branches. DSA-MR fusion imaging showed that the paramedian artery and the short circumferential artery ran around and into the pontine infarct lesion. Additionally, one of the paramedian arteries was occluded. Those neuroradiological findings coincided with the pathological concept of BAD. DSA-MR fusion imaging can prove the pathological concept of BAD.
Full Text of this Article in Japanese PDF (731K)

(CLINICA NEUROL, 59: 525|529, 2019)
key words: branch atheromatous disease (BAD), DSA-MR fusion imaging, plaque imaging

(Received: 8-Mar-19)