![]() ![]() Locating ROIs within tiny and thin intracranial arterial wall is not convenient and can be affected by errors and partial volume averaging effects. A previously used quantitative measurement of vessel wall enhancement used a region-of-interest (ROI) method ( 15). However, their methods of analyses were in general subjective and qualitative. Some studies demonstrated that the enhancement of intracranial arterial walls was a marker for active diseases and a potential marker for culprit atherosclerotic lesions ( 13, 15). Recently, several reports describe visualizing intracranial arterial walls using a high-resolution magnetic resonance imaging (MRI) ( 12, 13, 14). Localization of offending arteries could be used for proper treatment guidelines, e.g., choosing between stenting and medical therapy ( 9, 10, 11). Therefore, detection of offending intracranial arteries could help elucidate pathophysiology of acute ischemic stroke associated with intracranial arterial atherosclerosis. Conversely, acute distal subcortical infarcts or acute lacunar infarcts on a MCA perforator territory can be categorized as SAD ( 8). For middle cerebral artery (MCA), MCA territorial infarcts and striatocapsular infarcts including proximal subcortical infarcts correspond to PAD ( 7). The second, a small artery disease (SAD), results from an occlusion of small perforator arteries containing atherosclerotic plaques ( 6). The first is a parent artery disease (PAD) or a large vessel disease, which is due to the atherosclerosis in large arteries. Intracranial atherosclerosis could result in two types of ischemic stroke ( 3, 4, 5). ![]() Atherosclerosis of intracranial arteries is one of the major causes of acute ischemic stroke ( 1, 2). ![]()
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