Measurement of basilar artery bending and elongation by magnetic resonance cerebral angiography

Nishikata, Manabu; Hirashima, Yutaka; Tomita, Takahiro; Futatsuya, R; Horie, Yukio; Endo, Shunro

doi:10.1016/j.archger.2003.10.006

Cited by 26 publications

(27 citation statements)

References 6 publications

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“…The pearl-and-string sign was suggested by a previous study to be related to rebleeding in patients with SAH due to siVAD [31]; in addition, it may also be related to initial bleeding from unruptured siVAD, as shown in the present study. One previous study which evaluated morphological characteristics of the basilar artery suggested that longitudinal growth of the basilar artery depends on aging, while bending is induced by other factors [13]. One of these factors may be vertebrobasilar artery flow dynamics which were modified by dominance of the VA, VUBA and PICA.…”

Section: Discussionmentioning

confidence: 99%

“…‘Steep VA’ was defined as VUBA >45°. Basilar artery length was defined as the distance between the basilar top and VA union and basilar artery bending was defined as the longest distance from the line used in measuring the length of the basilar artery to the greatest bending point of the basilar artery, as described in a previous study [13] (fig. 2c).…”

Section: Methodsmentioning

confidence: 99%

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Differences in Vertebrobasilar Artery Morphology between Spontaneous Intradural Vertebral Artery Dissections with and without Subarachnoid Hemorrhage

Matsukawa¹,

Shinoda²,

Fujii³

et al. 2012

Cerebrovasc Dis

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Background: Patients with spontaneous intradural vertebral artery dissection (siVAD) developing subarachnoid hemorrhage (SAH) have been observed to have poor outcomes. Factors predisposing siVAD patients to SAH are not well known. We aimed to investigate the clinical and vertebrobasilar artery morphological characteristics associated with SAH in patients with siVAD. Methods: We reviewed 103 consecutive patients with siVAD managed at our facility between July 2003 and June 2012. We divided the patients into groups, with (n = 22) and without (n = 81) SAH, and compared clinical and vertebrobasilar artery morphological characteristics between them. The vertebral-union-basilar angle (VUBA) was defined as the most acute angle between the line of the basilar artery trunk and the line of the vertebral artery at the vertebral union on 3-dimensional magnetic resonance angiography, computed tomographic angiography, or digital subtraction angiography. ‘Steep vertebral artery’ was defined as VUBA >45°. Basilar artery bending was defined as the longest distance from the line which connected the basilar top and vertebral artery union to the greatest bending point of the basilar artery. Results: Stepwise logistic regression analysis was performed using variables that were marginally or significantly associated with SAH on univariate analysis (p < 0.10) and that were thought to be clinically important for SAH. It showed SAH patients to have significantly higher proportions of current smoking (OR: 7.7; 95% CI: 2.7–22; p = 0.0015), dissection of the dominant vertebral artery (OR: 4.9; 95% CI: 1.8–13; p = 0.043), steep vertebral artery of the dissecting side (OR: 7.2; 95% CI: 2.6–20; p = 0.0023), posterior inferior cerebellar artery involvement (OR: 4.0; 95% CI: 1.3–13; p = 0.011), basilar artery bending <3 mm (OR: 3.4; 95% CI: 1.3–9.5; p = 0.0040), and pearl-and-string sign (OR: 5.7; 95% CI: 2.0–16; p = 0.0033). Conclusions: We suggest that the clinical and vertebrobasilar artery morphological characteristics demonstrated in the present study may be related to SAH induced by siVAD. Although all patients with siVAD should be closely monitored, those with siVAD who have these characteristics should perhaps be more closely followed than those who do not have such features.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Differences in Vertebrobasilar Artery Morphology between Spontaneous Intradural Vertebral Artery Dissections with and without Subarachnoid Hemorrhage

Matsukawa¹,

Shinoda²,

Fujii³

et al. 2012

Cerebrovasc Dis

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“…Hence, the present method is effective for measuring the degree of angulation of the BA quantitatively. Previous methods for analyzing BA geometry were largely dependent on 2D axial images (XY sections only) 25,26) or maximum intensity projection (MIP) images 9,16,27) . However, the geometry of the BA cannot be measured appropriately using previous conventional methods for the following reasons: 1) the reference points frequently overlap and are obscured, and 2) the BA angles and distances are measured on randomly projected images, especially when using MIP images.…”

Section: Discussionmentioning

confidence: 99%

“…Among the morphological features of the BA, a larger angle at the vertebrobasilar junction was found to be independently associated with DPLI, even after adjusting for potential confounders, including vascular risk factors. The geometry of the BA has been measured previously using angiographic images 9) . We modified this method in order to improve our quantitative analysis using 3D Cartesian coordinates and 2D projection images.…”

Section: Discussionmentioning

confidence: 99%

Basilar Artery Angulation in Association with Aging and Pontine Lacunar Infarction: A Multicenter Observational Study

Jeong

Nam

Kim

et al. 2015

J Atheroscler Thromb

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Aim: Deep pontine lacunar infarction (DPLI) not involving the basal pial surface of the medial part of the pons, is known to be a small vessel disease in the territory of the basilar artery (BA). In the present study, we examined whether morphological features of the BA differ in individuals with an advanced age and may be associated with DPLI. Methods: This study included 338 healthy subjects and 78 patients with DPLI treated at the stroke centers of three university hospitals in Korea. Time-Of-Flight magnetic resonance angiographic images were transported to a central lab and analyzed blind to obtain the clinical data. For the quantitative analysis, the BA was projected two-dimensionally in the anteroposterior and lateral views and perceived as triangles of the vertebrobasilar junction, angulation point and BA division. The angles and triangular areas were summated into angulation indexes and used to quantify the degree of BA tortuosity. Results: The BA showed a more acute angle at the angulation point in the elderly patients than in the healthy subjects. Compared to the healthy subjects, the DPLI patients exhibited significantly larger angles at the vertebrobasilar junction, in addition to the acute angles noted at the angulation point. A unit increase in the BA angle indexes at the vertebrobasilar junction and angulation points for DPLI was found to have an odds ratio of 1.15 (95% confidence interval, 1.05-1.26) and 0.95 (95% CI, 0.91-0.99), respectively, even after adjusting for potential confounders. Conclusions: The angulation point of the BA becomes more acute in elderly individuals. In this study, the vertebrobasilar junction showed a larger angle in the patients with DPLI than in the healthy controls. J Atheroscler Thromb, 2015; 22: 509-517.

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“…Basilar artery length (BAL) refers to a standard line length which was drawn from the top of the BA to union of both VAs. Bending length (BL) refers to the vertical length between the middle point of the width of the BA at the point of greatest bending and the standard line 14 (Fig. 1).…”

Section: Mr Protocolsmentioning

confidence: 99%

Perfusion by delayed time to peak in vertebrobasilar dolichoectasia patients with vertigo

Peng

Zhang

et al. 2018

Ann Clin Transl Neurol

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ObjectiveTo investigate the association between the perfusion magnetic resonance imaging (MRI) and vertebrobasilar dolichoectasia (VBD) in vertigo patients and at least one vascular risk factor.MethodsWe studied 289 patients with vertigo (spinning, swaying, nausea, vomiting, and unsteady gait) who performed multimode MRI. Maximum diameter and tortuous parameters of the basilar artery and vertebral arteries were calculated using magnetic resonance angiography. Relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), mean transit time (MTT), and time to peak (TTP) maps were evaluated by dynamic susceptibility contrast‐enhanced perfusion imaging. Association of perfusion MRI and VBD was evaluated by nonparametric tests and receiver‐operating characteristic curve was constructed to predict posterior ischemic stroke in VBD patients.ResultsThe prevalence of VBD was 26.6% (n = 77/289) in our study. Male gender was the risk factor of VBD by multivariate analysis. BA diameter was significant statistics between ischemic stroke and nonischemic stroke patients. TTP in bilateral lower cerebellum, superior cerebellum, bilateral pons, and occipital and temporal lobes region of interests was significantly delayed in VBD versus non‐VBD patients, while rCBF, rCBV, and MTT parameters were not significant differences. TTP in the right temporal lobe delayed by 21.96 ms was the best predictive value and the mean TTP predictive threshold value in all ROIs was 22.67 ± 1.48 ms.Interpretation VBD leads to the hypoperfusion of posterior circulation territory characterized by delayed TTP. Delayed TTP in cerebellum, pons, and occipital and temporal lobes fed by vertebrobasilar arteries predicted the occurrence of posterior ischemic stroke in VBD patients.

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Measurement of basilar artery bending and elongation by magnetic resonance cerebral angiography

Cited by 26 publications

References 6 publications

Differences in Vertebrobasilar Artery Morphology between Spontaneous Intradural Vertebral Artery Dissections with and without Subarachnoid Hemorrhage

Differences in Vertebrobasilar Artery Morphology between Spontaneous Intradural Vertebral Artery Dissections with and without Subarachnoid Hemorrhage

Basilar Artery Angulation in Association with Aging and Pontine Lacunar Infarction: A Multicenter Observational Study

Perfusion by delayed time to peak in vertebrobasilar dolichoectasia patients with vertigo

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