Abstract 3780: MR Imaging Of The Intracranial Vessel Wall In Paediatric Stroke

Background Arteriopathy in childhood arterial ischaemic stroke (AIS) is common and is postulated to be a predictor of outcome. The distinction between inflammatory (transient cerebral arteriopathy [TCA], CNS angiitis) and non-inflammatory (arterial dissection, moyamoya) arteriopathies is vital to guide acute management decisions. Currently available non-invasive angiographic imaging techniques are inadequate to reliably distinguish inflammatory from non-inflammatory causes. Conventional catheter angiography, the gold standard, is invasive and not always feasible. Objective: To report the findings of a novel non-invasive arterial wall MR imaging technique in three children with arterial ischemic stroke due to arteriopathy. Method: 3-Tesla T1-weighted 2D FLAIR fast spin echo sequence (slice thickness 3mm, matrix size 512x512) in plane and perpendicular to the vessel of interest were performed in three children with AIS before and after intravenous administration of Gadolinium, in addition to routine sequences. Results: The first child had TCA ( Fig. 1 ), the second had arterial dissection and the third had CNS angiitis (see table ). Conclusion: Our series highlights the utility of a novel non-invasive MR imaging technique of vessel wall as distinct patterns of vessel wall enhancement could be demonstrated in children with TCA, arterial dissection and CNS angiitis. Prospective studies are required to further assess the diagnostic utility of vessel wall enhancement in children with arteriopathy-related AIS. This would also help us understand the pathophysiologic mechanism of this finding. Table 1. y=years; F=female; M=male; dICA=distal internal carotid artery; BA=basilar artery