Background: Solitary pontine infarct is divided into paramedian pontine infarct (PPI) and small deep pontine infarct (SDPI). High-resolution MRI is currently the most useful imaging method to characterize vessel walls and detect atherosclerotic plaques of the intracranial arteries. However, high-resolution MRI is not included in the routine imaging protocol for patient with acute stroke. We intend to determine the role of conventional MRI and MRA of the brain in solitary pontine infarct. Methods: Fifty patients with solitary pontine infarct underwent a MRI study of the brain on T1-weighted image, T2-weighted image and post-gadolinium T1-weighted image to assess the presence of atherosclerotic plaque, and MRA of the brain using 3-dimensional time-of-flight MRA (3D TOF MRA) to assess the basilar artery flow. The basilar artery assesses by axial T2-weighted image was scored as “presence of plaque” or “absence of plaque” and the 3D TOF MRA of the basilar artery is scored as “normal”, “irregular” or “stenosis” ≥ 30%. Pontine infarct is divided into paramedian pontine infarct (PPI) and small deep pontine infarct (SDPI) groups. Results: Thirty-five patients had PPI and 15 had SDPI. Axial T2WI MRI of the brain detected basilar artery plaques in 50% of patients with pontine infarction: 51.4% (18 of 35 cases) in PPI and 46.7% (7 of 15 cases) in SDPI. No plaque was found in all cases of normal-appearing 3D TOF MRA and the plaque was identified in all patients with basilar artery stenosis on the 3D TOF MRA. Conclusion: The basilar artery atherosclerotic branch disease is frequently detected in both groups of solitary pontine infarct (PPI and SDPI). Conventional MRI and MRA of the brain are useful imaging methods that help characterize basilar wall abnormalities.
Magnetic Resonance Imaging