Clinical Usefulness of Preoperative MCA Anatomical Scanning MRI in Thrombectomy Therapy for Acute Anterior Circulation Vessel Occlusion

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Objective: The aim of the present study was to evaluate the usefulness of the T2-weighted three-dimensional sequence method, known as “basi-parallel anatomical scanning (BPAS)-magnetic resonance imaging (MRI),” in demonstrating the running course of the obstructed middle cerebral artery (MCA) before acute mechanical thrombectomy.

Methods: Patients whose M1 part and internal carotid artery (ICA) were occluded on preprocedural MRA, but well demonstrated on MCA anatomical scanning (MAS)-MRI were enrolled in this study. The MAS-MR images for patients in whom thrombectomy was performed were compared with the post-thrombectomy angiography. We compared the running course of the C1-M2 bifurcation on MAS-MRI and angiography after thrombectomy, and the results were classified into 3 groups (Excellent, Good, and Poor).

Results: A total of 13 patients (range: 54–89) were enrolled, among whom 12 underwent thrombectomy. We compared MAS-MRI and post-thrombectomy angiography in 10. On comparison between MAS-MRI and post-procedural angiography, visualization was excellent in six (60%) patients. The mean age was 75.7 years, ranging from 54 to 89, and 6 were males. 3 patients had ICA occlusion and seven had MCA occlusion.

Conclusion: MAS-MRI was considered useful to clarify the running course of the MCA before acute mechanical thrombectomy.