To observe the imaging characteristics of acute ischemic stroke (AIS) of the anterior choroidal artery (AchA), and then explore the diagnostic value of morphological features of AchA infarction.

One hundred consecutively patients with AIS who had an imaging diagnosis of AchA infarction were selected. Data including age, gender, stroke history, hypertension, diabetes, atrial fibrillation (AF), and coronary heart disease were recorded. The severity of illness was evaluated using the National Institute of Health stroke scale (NIHSS) and NIHSS score at admission was recorded. All patients underwent brain MR imaging (MRI) and diffusion weighted imaging after admission. According to the maximum diameter of infarcts, they were divided into small infarcts (maximum diameter <15 mm), medium infarcts (maximum diameter 15-20 mm), and large infarcts (maximum diameter >20 mm).

The diameter of AchA infarct was 6.1-29.3 mm, with an average of (14.6±4.8) mm, including 55 small infarctions, 31 medium infarctions, and 14 large infarctions. No difference was found in terms of hypertension, diabetes, atrial fibrillation, coronary artery disease, or stroke history between cord-like infarcts and infarcts of other shapes. In terms of the proportion of speech disorders and diameter, there were greater in patients with cord-like infarcts were than in patients with infarcts of other shapes (P=0.006, 0.001). There was no significant difference in hypertension, diabetes, heart disease and stroke history among the patients with large, medium and small infarcts, but there was a significant difference in the proportion of speech disorder and sensory disorder (P=0.009, 0.047).

AchA infarcts mostly manifest as long cord-like infarcts on diffusion weighted imaging, and the shape is associated with the size of infarcts. The morphological characteristics of infarcts have diagnostic value for AchA infarction.