MRI characteristics of carotid bulb atypical fibromuscular dysplasia in black stroke patients

Background and purpose: In black stroke patients, a particular form of fibromuscular dysplasia dysplasia; (FMD), called atypical FMD (aFMD), is involved in stroke mechanism. The high rate of stroke Stroke; recurrence under medical treatment leads to propose surgery in such patients. Regarding its Black; location level on the carotid bulb, aFMD is often confused with atherosclerosis or free-floating Magnetic resonance thrombus. Nowadays, only histology can confirm the diagnosis. MRI of aFMD has never been assessed. Materials and methods: The constitution of a black patient's cohort with aFMD-related ischemic stroke is currently in progress in the French West Indies, Martinique. In patients scheduled for surgery, MRI of the carotid bifurcation was analyzed preoperatively, with subsequent histological examination of the excised specimen. The first four black stroke patients with MRI and histological findings are described. Results: On imaging, aFMD lesion was homogeneous with isosignal on T2-weighted sequences and slight hypersignal on T1-weighted sequences with mild gadolinium enhancement of the inner layer. Histological findings confirmed the aFMD mainly located in the intima. Conclusions: aFMD generates a particular MRI pattern in our four patients, which could increase the diagnosis accuracy. Carotid bulb lesion in black stroke patients should suggest aFMD and MRI analysis may contribute to rule out differential diagnoses. (C) 2015 Elsevier Masson SAS. All rights reserved.