BACKGROUND: Middle cerebral artery (MCA) plaques are a leading cause of ischemic stroke (IS). Plaque inflammation is crucial for plaque stability and urgently needs quantitative detection. PURPOSE: To explore the utility of Controlled Aliasing in Parallel Imaging Results in Higher Acceleration (CAIPIRINHA)-Dixon-Time-resolved angiography With Interleaved Stochastic Trajectories (TWIST) (CDT) dynamic contrast-enhanced MRI (DCE-MRI) for evaluating MCA culprit plaque inflammation changes over stroke time and with diabetes mellitus (DM). STUDY TYPE: Prospective. POPULATION: Ninety-four patients (51.6 ± 12.23 years, 32 females, 23 DM) with acute IS (AIS
N = 43) and non-acute IS (non-AIS
14 days <
stroke time ≤ 3 months
N = 51). FIELD STRENGTH/SEQUENCE: 3-T, CDT DCE-MRI and three-dimensional (3D) Sampling Perfection with Application optimized Contrast using different flip angle Evolution (3D-SPACE) T1-weighted imaging (T1WI). ASSESSMENT: Stroke time (from initial IS symptoms to MRI) and DM were registered. For 94 MCA culprit plaques, K STATISTICAL TESTS: Shapiro-Wilk test, Bland-Altman analysis, Passing and Bablok test, independent t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, receiver operating characteristics (ROC) with the area under the curve (AUC), DeLong's test, and Spearman rank correlation test with the P-value significance level of 0.05. RESULTS: K DATA CONCLUSION: Imaging by CDT DCE-MRI may allow to quantitatively evaluate MCA culprit plaques over stroke time and DM. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.