MR-ANGIOGRAPHY IN ACUTE CEREBRAL-ISCHEMIA OF THE ANTERIOR CIRCULATION- A PRELIMINARY-REPORT

PURPOSE: To determine the prevalence of major vessel occlusion in case s of acute cerebral ischemia of the anterior circulation by using MR a ngiography and to assess the frequency of spontaneous thrombolysis. ME THODS: Thirty patients with an initial clinical diagnosis of possible acute stroke of the anterior circulation made within 24 hours of the e vent were studied with conventional T2-weighted MR imaging and with tw o-dimensional and three-dimensional time-off-light MR angiography, Stu dies were repeated if the initial study showed partial or complete occ lusion, RESULTS: Of the 30 patients studied, six (20%) had a final dia gnosis of a transient ischemic attack and 24 (80%) had a stroke of the anterior circulation as confirmed by T2 abnormalities and persistence of clinical symptoms. Twelve (50%) of the stroke patients had a major vessel abnormality, either partial or complete occlusion, at MR angio graphy. Of these 12 patients, nine subsequently had follow-up MR angio graphy, and only two of these had a change in the findings. One patien t with diminished now signal had progression of the occlusion and anot her patient had flow signal in a vessel where no flow was seen initial ly. CONCLUSION: MR angiography can show patients with acute cerebral i schemia and major vascular occlusive disease. Of those with partial or complete occlusion, progression of thrombus or spontaneous recanaliza tion occurs infrequently.