Evaluation of Lenticulostriate Arteries Changes by 7 T Magnetic Resonance Angiography in Type 2 Diabetes

Abstract

Aim: Progress in neuroimaging techniques allows us to investigate the microvasculature characteristics including lenticulostriate arteries (LSA), which are closely associated with lacunar infarction. Because ischemic stroke is a more critical health problem in East Asian than in other populations, in order to clarify pathological changes underlying cerebral small vessel disease (SVD), we projected an imaging analysis of LSA using high-resolution brain magnetic resonance imaging (MRI) in middle-aged Japanese subjects with type 2 diabetes.Methods: Twenty-five subjects with type 2 diabetes and 25 non-diabetic control subjects underwent 7 Tesla (7 T) brain MRI. The prevalences of SVD and LSA structural changes were determined in each group.Results: SVD prevalence did not differ significantly between the type 2 diabetes and control groups. The average numbers of stems, as well as numbers of branches, of LSA were significantly smaller in diabetic subjects than non-diabetic control subjects. The signal intensity of LSA was markedly decreased, indicating reduced blood flow in type 2 diabetes.Conclusion: In spite of the prevalence of SVD being similar, structural changes and decreased signal intensity of LSA were highly detected in diabetic subjects compared with non-diabetic controls, suggesting that 7 T MRA enables us to determine LSA impairment prior to the development of SVD. Early detection of LSA impairment allows us earlier interventions aimed at the prevention of atherosclerotic events.

High Prevalence of Cerebral Small Vessel Disease on 7T Magnetic Resonance Imaging in Familial Hypercholesterolemia

“…The maximum intensity projection (MIP) images obtained by MRA, including the anterior and middle cerebral arteries focused on LSA, were reconstructed at the oblique coronal planes parallel to the LSA (thickness, 20 mm; interval, 1.0 mm; partitions, 45) with a 90 mm FOV, and at the axial planes (thickness, 2 mm; interval, 0.5 mm; partitions, 92) and the bilateral sagittal (thickness, 20 mm; interval, 0.6 mm; partitions, 40) planes with a 100 mm FOV 22, 23) . All reformatting of images was performed by one of the authors (I.U.)…”

“…To delineate LSA distributions, we overlaid line tracings that were based on the 3D LSA images onto the conventional two-dimensional MIP images. By using these images, the morphological characteristics of LSA, including stems, branches, length, and tortuosity, for comparison between FH patients, and controls were analyzed using Vox-base II (J-MAC SYSTEM, Inc., Japan), as previously reported 23) .…”

“…A board certified senior radiologist (MS, with more than 20 years of experience), blinded to the clinical status of the patients, visually evaluated all images twice each for the presence of any abnormalities. This radiologist concurrently determined narrowing or interruption of the LSA, as indicated by a decrease in signal intensity on the MRA-MIP images due to reduced blood flow, findings collectively referred to as “impaired LSA visualization” 23) . Conventional brain MRI was used to evaluate DWMH and periventricular hyperintensity (PVH) of Fazekas grade II or III, lacunar infarctions, brain atrophy, and microbleeds.…”

The Impact of Diabetes Mellitus and Admission Hyperglycemia on Clinical Outcomes after Recanalization Therapies for Acute Ischemic Stroke: STAY ALIVE National Prospective Registry

“…In addition, stroke outcomes are worse in diabetic patients, as diabetes has adverse effects on the vasculature including endothelial dysfunction, inflammation, and prothrombotic state [ 2 , 3 , 4 ]. Furthermore, diabetes also leads to a decrease in the size and the number of branches of lentriculostriate arteries that potentially affect the local cerebral circulation leading to greater ischemic deficits and delayed recovery after stroke [ 5 ].…”

A Processing Pipeline for Quantifying Lenticulostriate Artery Vascular Volume in Subcortical Nuclei

“…In most studies, the number of LSA stems and branches arising from the first segment of the bilateral ACAs and MCAs are counted manually (7,9,12). Some studies have measured the angles, lengths, and curvatures of the longest LSAs on 2D maximum intensity projection (MIP) images (6,13,14) or 3D extracted vessels (15,16). In addition, LSA orifices (8) and vascular densities obtained with rough threshold segmentations (17) have also been proposed.…”