PMC8564011_01
(A) Baseline MR scan showed two plaques in the proximal (blue arrow) and middle (yellow arrow) of the right vertebral artery (VA) V4 segment. (B) The patient underwent the 1st MR follow-up scan 3 months after index stroke. MRA and MR-VWI showed a new plaque (red arrow) in the distal right VA V4 segment with severe stenosis and high enhancement ratio (ER). (C) Most of plaque features showed slightly regression at the 2nd follow-up MR scan 6 months after index stroke. (D) The 3rd follow-up MR scan 12 months after index stroke showed that the degree of stenosis, plaque-wall contrast ratio (CR) and ER of the plaque in the distal right VA V4 segment were back to baseline and slightly improved in the other two plaques. MRA, MR angiography; MR-VWI, MR vessel wall imaging; MPR, multiplanar reconstruction; Pre-, pre-contrast MR-VWI; Post-, post-contrast MR-VWI.
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F1
MRA and pre- and post-contrast MR-VWI (Fan et al.,; Yang et al.,) was pursued. MRA revealed two stenotic lesions in the right VA (Figure 1 yellow and blue arrows). Despite the moderate regression of LDL and an appreciable drop in plaque-wall CR and/or plaque ER in the two originally identified lesions, a new lesion in the distal right VA with a diffusive and severe lumen narrowing and strong vessel wall enhancement was observed (Figure 1 red arrow).
Quantitative measurement results of plaque features. MRA, MR angiography; MR-VWI, MR vessel wall imaging; VA, vertebral artery; CR, plaque-wall contrast ratio; ER, plaque enhancement ratio.
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F2
The quantitative measurement results of plaque features are shown in Figure 2.
Timeline of clinical management and MR examinations.
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F3
A schematic diagram showing the time course of clinical management and MR examinations is presented in Figure 3.