The Longitudinal Distribution and Stability of Curved Basilar Artery Plaque: A Study Based on HR-MRI

Abstract

This study aims to evaluate the differences in the characteristics of atherosclerotic plaques in the proximal, curved, and distal segments of the curved basilar artery (BA) through high-resolution magnetic resonance imaging(HR-MRI). Methods:The imaging and clinical data of 146 patients were retrospectively analyzed. On the basis of threedimensional (3D) time -of -flight magnetic resonance angiography (3D-TOF-MRA), 51 patients with BA curvature were selected for the study. The BA plaque is divided into three groups: proximal, curved, and distal. Plaques were identified and analyzed according to spin echo acquisition imaging via T1-weighted 3D volumetric isotropic Tse acquisition (T1W-3D -VISTA), and compare the differences in clinical related factors and plaque characteristics between groups. Diffusion-weighted imaging (DWI) and/or T2WI identified brainstem infarction. The patients were divided into symptomatic and asymptomatic groups. The correlation between plaque location and symptoms was identified and analyzed.Results: Among 51 patients, a total of 376 plaques were detected. Plaques in the proximal and curved segments are more common than those in the distal segments. Proximal plaques are more likely to have intraplaque hemorrhage (P = 0.002 ＜0.05). There was no significant difference in the distribution of criminal plaques and non-criminal plaques between each group (P = 0.36 ＞0.05). Conclusion:Plaques in the proximal and curved segments of the BA are more common than those in the distal segments. The proximal plaque is more prone to intraplaque hemorrhage.patients with ischemic stroke and transient ischemic attack (TIA) 4) . The distribution is closely related to the location of cerebral infarction in the blood supply area 5) , which affects the clinical manifestations and even prognosis of patients. The changes in vascular geometry and the geometric relationship in the posterior circulation vessels are greater than those in the anterior circulation. The forms of the posterior circulation vessels vary greatly from person to person, including the course of the BA and angle of the vertebral artery and the BA, etc 6) . The curvature of BA is considered to be a chronic process that exists for a long time in adults 7) . Studies have shown that the formation and distribution of BA plaque is closely

Predicting acute ischemic stroke using the revised Framingham stroke risk profile and multimodal magnetic resonance imaging

“…The responsible blood vessels were determined based on the patient’s clinical symptoms and the location of the DWI diffusion limitation. The location of the responsible plaque was defined as the plaque at the same layer as the lesion or at the adjacent upper/lower layer ( 18 ), or the plaque at the narrowest point of the blood vessel. The presence or absence of intraplaque hemorrhage (IPH) and plaque enhancement were analyzed, and the signal intensity (SI) of the plaque and brain gray matter before and after enhancement was measured.…”

Effect of Mid-Basilar Artery Angle and Plaque Characteristics on Pontine Infarction in Patients with Basilar Artery Plaque

“…However, some researchers have found that IPH was also observed in asymptomatic carotid atherosclerotic plaques and plaques without stenosis 36,37) . In addition, a study suggested that plaques proximal to the BA are more prone to IPH 38) . A small number of plaques showed IPH in our study, and no difference was found between the two groups .…”

“…Most previous studies mainly focused on the relationship between the tortuosity of the BA and the plaque presence, location, and mean wall thickness 14,16,18,38) , or they only focused on differentiating plaque characteristics on HRMRI between symptomatic and asymptomatic patients 39) . However, very few studies have established the relationship between different mid-BA angle and plaque characteristics and pontine infarction when the BA has plaques.…”

Application of high-resolution MR imaging in intracranial diseases

“…With an improved quality of life and an aging population, ICAS-induced cerebrovascular diseases are increasingly prevalent in clinical practice [8] . Atherosclerotic plaque is the most important cause of stroke and is often associated with unstable plaques [9]. Intracranial atherosclerotic disease (ICAD) is defined as atherosclerotic lesions affecting the large intracranial artery at the bottom of the brain, including the intracranial carotid artery (ICA), middle cerebral artery (MCA) and basilar artery.…”