title: The advantage of high-resolution MRI in evaluating basilar plaques: a comparison study with MRA.
abstract: OBJECTIVE
  Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke; however it is rather neglected. Vessel wall visualization by high resolution magnetic resonance imaging (HRMRI) might provide more accurate information.
  
  
  METHODS
  A total of 219 consecutive patients with acute ischemic stroke underwent MRI, MRA and proton-density weighted HRMRI. Using HRMRI, the patients were divided into 3 groups with respect to basilar plaques: no plaque (n = 85), minimal plaque (n = 72) and apparent plaque (n = 62). Demographics and characteristics were compared between the groups, and the extents of stenoses calculated from MRA versus HRMRI data were also compared. Factors potentially associated with basilar plaque were validated by multivariate analysis.
  
  
  RESULTS
  Patients with apparent plaque had higher frequencies of diabetes mellitus, lower high-density lipoprotein and higher hemoglobin A1c, erythrocyte sedimentation rate and homocysteine. Of the 62 cases of apparent plaque, severe stenosis (>50%) was observed in 10 (16%) by MRA and in 27 (43%) by HRMRI, which points to overestimation of plaques by HRMRI. In addition, no stenosis was evident on MRA in 13 patients with apparent plaque even though they had up to 72% stenosis on HRMRI. After adjusting for covariates, basilar artery apparent plaque was independently associated with old age, previous stroke, diabetes mellitus, low HDL and high levels of homocysteine.
  
  
  CONCLUSIONS
  Basilar artery stenosis with plaque is more accurately detected using HRMRI than MRA. In addition, the associated risk factors differ somewhat. The use of HRMRI for evaluating ICAS deserves more attention.
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-792, Republic of Korea.
authors.forename: Young Seo
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung-Hwan
authors.initials: SH
authors.lastname: Lim
authors.forename: Ki-Wook
authors.initials: KW
authors.lastname: Oh
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Koh
authors.forename: Juhan
authors.initials: J
authors.lastname: Kim
authors.forename: Sung Hyuk
authors.initials: SH
authors.lastname: Heo
authors.forename: Dae-Il
authors.initials: DI
authors.lastname: Chang
authors.forename: Young-Jun
authors.initials: YJ
authors.lastname: Lee
authors.forename: Hyun Young
authors.initials: HY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000473:pathology*; D002533:Cerebral Angiography / Q000379:methods*; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D012042:Registries; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology