High-risk features of basilar artery atherosclerotic plaque

Abstract

IntroductionHigh-resolution magnetic resonance imaging (HR-MRI) is used to characterize atherosclerotic plaque. The present study aimed to determine the high-risk features of the basilar artery (BA) atherosclerotic plaque.MethodsPatients with advanced BA stenosis were screened. The features including the ruptured fibrous cap (RFC), lipid core, intraplaque hemorrhage (IPH), plaque enhancement, and calcification were assessed by using high-resolution MRI. The relationship between the features and acute infarction was analyzed.ResultsFrom 1 June 2014 to 31 December 2018, a total of 143 patients with 76 new strokes were included. RFC was identified in 25% of symptomatic and 10.4% of asymptomatic patients. IPH was identified in 48.7% of symptomatic and 25.4% of asymptomatic patients. RFC (3.157, 95% CI 1.062 to 9.382, p = 0.039) and IPH (2.78, 95% CI 1.127 to 6.505, p = 0.026) were independent risk factors for acute infarction.ConclusionOur study showed that RFC and IPH of BA plaque were independent risk factors for acute infarction.

The Role of High-Resolution Magnetic Resonance Imaging in Cerebrovascular Disease: A Narrative Review

“…HRMRI can provide insight into the underlying vascular biological differences between symptomatic and asymptomatic MCA stenoses, which can help stratify stroke risk and modify treatment strategies. For the posterior circulation, rupture FC and IPH of basilar artery plaques are independent risk factors for acute infarction [ 52 ]. One study [ 22 ] found that some patients with posterior circulation infarction had vertebrobasilar artery atherosclerosis on HRMRI, but digital subtraction angiography (DSA) was normal, suggesting that infarction may be due to penetrating artery disease secondary to vertebrobasilar artery atherosclerosis.…”

Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques

“…In contrast, HR-MRI demonstrates the capacity to visualize the fibrous cap effectively. Instances of fibrous cap rupture are identifiable by the presence of partially obscured and irregular surfaces within T 1 -weighted or T 2 -weighted images (157).…”