Table 5.

Select studies using VW-MRI in an ESUS/CS population for evaluation of aortic arch atherosclerosis.

Study	Imaging technique	Vessel	Key imaging characteristics	Select results
Harloff et al. (110)	3T. ECG-synchronized pre- and post-contrast 3D T1W FS, 2D T2W, time resolved (CINE) imaging	Asc, Arch, Desc	Max Wall Thickness of high risk plaques (≥4 mm or superimposed thrombi)	MRI identified high risk pathologies in 8 of 26 (30.8%) CS patients after standard diagnostic work-up including TEE
Harloff et al. (111)	3T. 3D contrast-enhanced MRA, ECG-gated 3D T1W RF-spoiled FS bright blood GRE, 2D T2W TSE, 3D CINE T1W	Asc, Arch, Desc	Complex plaques (≥4 mm thick, ulcerated, or with mobile thrombus)	MRI showed additional complex plaques in 19 of 58 (32.8%) CS patients after diagnostic work-up including TEE
Wehrum et al. (107)	3T. 3D T1W bright-blood, 3D T2W black-blood, 3D PD black-blood. 4D flow used to visualize 3D blood flow within the thoracic aorta	Asc, Arch, Desc	Plaque thickness, surface irregularities, thrombus, IPH, calcification, fibrous tissue	Plaques ≥4 mm more frequent in CS patients than controls [22 (55.0%) vs. 10 (16.7%); p < 0.001]. Of those with plaques ≥4 mm, AHA-LT VI plaques higher in stroke patients (17.5% vs. 3.3%, p < 0.001). No significant difference between groups for plaques <4 mm thickness [23 (57.5%) vs. 33 (55.0%); p = 0.81]
Jarvis et al. (120)	1.5T. 4D flow MRI and 3D T1W black-blood TSE	Mid-Asc, Arch, proximal-Desc, distal-Desc	Aortic wall thickness (3D T1W black-blood), pulse wave velocity (PWV, measure of arterial stiffness) and voxel-wise mapping of flow reversal fraction (FRF)	Aortic PWV and FRF higher in CS patients (8.9 ± 1.7 m/s, 18.4 ± 7.7%) than younger controls (5.3 ± 0.8 m/s, p < 0.0167; 8.5 ± 2.9%, p < 0.0167), but not age-matched controls (8.2 ± 1.6 m/s, p = 0.22; 15.6 ± 5.8%, p = 0.22). Maximum aortic wall thickness higher in CS patients (3.1 ± 0.7 mm) than younger controls (2.2 ± 0.2 mm, p < 0.0167) and age-matched controls (2.7 ± 0.5 mm) (p < 0.0167)

VW-MRI, vessel wall MRI; T1W, T1 weighted; T, Tesla; RF, radiofrequency; FS, fat suppressed; PD, proton density; T2W, T2 weighted; CE MRA, contrast-enhanced magnetic resonance angiography; IPH, intraplaque hemorrhage; AHA-LT VI, American Heart Association lesion type VI; PWV, pulse wave velocity; FRF, flow reversal fraction; 95% CI, 95% confidence interval; Asc, Ascending aorta; Desc, Descending aorta; TSE, turbo spin echo; CS, cryptogenic stroke.