Distinct perforator hemodynamic phenotypes differentiate mechanisms of single subcortical infarction: In vivo evidence from 7T phase-contrast MRI

作者：Ning Wei, Yuyuan Xu, Yue Suo, Zheng Zhang, Wanlin Zhu, Hui Qu, Xiping Gong, Kehui Dong, Zixiao Li, Yongjun Wang, Zheng Zhang, Jing Jing · 发表于：International Journal of Stroke · 年份：2026 · DOI：10.1177/17474930261444936 · 被引用次数：1 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Advanced MRI Techniques and Applications、Coronary Interventions and Diagnostics

OBJECTIVE: Single subcortical infarction (SSI) arises from heterogeneous mechanisms, most commonly parent artery disease (PAD) or intrinsic small vessel pathology. However, whether these mechanisms produce distinct in vivo hemodynamic signatures within perforating arteries remains unknown. We aimed to determine whether lenticulostriate artery (LSA) hemodynamics differ between SSI subtypes and whether such differences provide mechanistic insight into SSI pathophysiology. METHODS: Patients with recent SSI confined to the LSA territory were prospectively enrolled and underwent 7T magnetic resonance imaging. Based on intracranial vessel wall imaging, patients were classified as SSI + PAD (ipsilateral middle cerebral artery (MCA) plaque on T1-weighted vessel wall imaging defined by eccentric wall thickening) or SSI - PAD (no ipsilateral MCA plaque). LSA flow velocity was quantified at the arterial ostium and distal segment using phase-contrast magnetic resonance angiography (PC-MRA), and along-vessel velocity decline was calculated. LSA morphology was assessed with time-of-flight MRA. Linear mixed-effects models adjusted for age and sex were used for group comparisons. RESULTS: Forty-two patients (21 SSI + PAD and 21 SSI - PAD) were included. In SSI + PAD, ostial velocity in the symptomatic hemisphere was significantly lower than in the contralateral hemisphere (7.25 vs. 9.61 cm/s; p < 0.001) and the symptomatic side of SSI - PAD (8.95 cm/s, p = 0.001), indicating proximal inflow ...