Ultrahighfield angiography in lacunar stroke
Research type
Research Study
Full title
Ultra highfield MRI in to detect thrombus in lacunar stroke
IRAS ID
253344
Contact name
Keith Muir
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
0 years, 10 months, 1 days
Research summary
Research Summary
We plan to use the new ultra-high-field (7T) MRI scanner to look for the cause of a certain type of stroke called a lacunar stroke. At the moment we don't know if lacunar stroke is caused by a blood clot coming from elsewhere (e.g. from the heart) and blocking a blood vessel, or by a problem with the vessel itself.
We know that it is possible to see some blood clots on standard MRI scans: they have a certain appearance on the T2* sequence, called the 'susceptibility vessel sign' (SVS), but standard MRI scans can't see the very small vessels that cause lacunar stroke. Clots see on SVS are more likely to come from the heart. We know that the T2* sequence on our new MRI scanner works well on healthy volunteers. We are going to recruit patients who have recently had an acute lacunar stroke and ask them to have a 7T scan. We will find out if it is possible to see the acute clot in the small vessels, and how easy it is to recruit patients into a 7T study directly after a lacunar stroke.Summary of Results
Small vessel disease is caused by disease of very small blood vessels in the brain. It causes around 25% of strokes. The exact reason for strokes is unclear, with uncertainty whether clots are responsible for blocking the flow of blood, as is the case in other types of stroke. Better understanding might lea to a different approach to treatment, which relies on clot-dissolving drugs at present.
Using a high resolution MRI scanner (7T magnetic field), we identified a possible small clot in a relevant location in 7 out of 20 (35%) people with a recent stroke due to likely small vessel disease. We were unable to confirm a blockage in a blood vessel, likely because the relevant vessels are too small to be reliably seen even using 7T MRI. This supports the possibility that a clot is reponsible for some strokes of this type.REC name
West of Scotland REC 3
REC reference
20/WS/0012
Date of REC Opinion
28 Jan 2020
REC opinion
Favourable Opinion