Visualization of culprit perforating artery in subcortical infarction using 3D MRI and angiography fusion image

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K16716
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Fujita Health University (2023); National Cardiovascular Center Research Institute (2020-2022)
• Principal Investigator: Koge Junpei 藤田医科大学, 医学部, 講師 (90866732)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 脳梗塞 / 穿通枝 / 脳血管造影 / MRI / 融合画像

Outline of Final Research Achievements

Visualizing the culprit perforating artery in subcortical infarction using in vivo imaging is challenging. We aimed to identify the culprit perforating arteries in subcortical infarctions and assess their morphology using an image fusion technique. Images were registered using an original fusion software. Of 118 patients, the culprit perforating artery was identified in 52 patients (44%). 27 (61%) patients exhibited stenosis in the proximal segment. Atrial fibrillation was more frequent in patients without stenosis in the proximal segment of the culprit perforating artery than in those with stenosis. The morphological characteristics of the culprit perforating arteries assessed using 3D-RA may be linked to the etiological mechanism of stroke. Our approach may potentially improve the accessibility and convenience of perforating artery evaluation, which could improve the diagnosis of stroke etiology in patients with subcortical infarctions.

Free Research Field

脳血管障害

Academic Significance and Societal Importance of the Research Achievements

本研究により、高解像度の拡大3D回転脳血管造影画像と3DMRIを正確に融合し、穿通枝領域の脳梗塞の原因となる責任穿通血管を可視化、同定する手法が確立された。穿通枝梗塞の中でも進行性かつ重度の後遺症を生じ得るbranch atheromatous disease (BAD)の存在が病理所見から提唱されているが、本研究で認められた責任穿通血管の近位部の狭窄はBADを生体の画像で示した重要な所見と考える。また、責任穿通血管の中には明らかな狭窄を認めない例も存在しており、穿通枝領域への塞栓症を示唆する所見と考えられる。本手法を用いた穿通枝自体の評価は穿通枝領域の脳梗塞の病型診断に有用と考える。