MR Visualization of Retrograde Aortic Flow Pattern in a Patient with Recurrent Embolic Strokes

Introduction

A 76-year-old patient with a history of recurrent left-hemispheric strokes within the last two years was referred for ECG-gated CT angiography (CTA) of the chest for the assessment of aortic plaque burden as a potential source of embolic stroke episodes. CTA revealed significant atherosclerotic plaques in the descending aorta as well as a moderate aortic isthmus stenosis with kinking (A–C). Significant carotid artery stenosis was excluded by contrast-enhanced MRA. Additional time-resolved three-dimensional phase-contrast MRI showed a retrograde flow pattern towards the supra-aortic vessels (D–F) suggesting recurrent embolism from the plaques in the descending aorta (see also supplementary online video, www.karger.com/doi/10.1159/000338540).

This case illustrates that visualization of flow patterns with time-resolved three-dimensional phase-contrast MRI provides additional information in patients with embolic strokes in whom ECG-gated CTA revealed significant plaque burden in the aortic arch and descending aorta.

Disclosure Statement

All authors declare that they have no competing financial, funding or contributorship interests.

Supplementary Material

Supplementary Online Video