title: Morphologic characteristics of atherosclerotic middle cerebral arteries on 3T high-resolution MRI.
abstract: OBJECTIVE
  There are limited studies on the morphologic characteristics of MCA atherosclerotic stenosis. Our aim was to quantitatively assess the remodeling pattern and plaque distribution of atherosclerotic MCAs with 3T high-resolution MR imaging.
  
  
  METHODS
  Eighty-seven consecutive patients with symptomatic atherosclerotic stenoses at the M1 segment of the MCA on DSA (50%-99%) were enrolled. The remodeling index was calculated as the Vessel Area at Maximal Lumen Narrowing/Reference Vessel Area. A remodeling index ≥ 1.0 was defined as positive remodeling, and a remodeling index < 1.0, as negative remodeling. Plaque distribution at the maximal lumen narrowing site was classified on the basis of the involvement of the superior, inferior, dorsal, or ventral MCA wall.
  
  
  RESULTS
  Forty-three of 87 patients were excluded due to poor imaging quality (n = 8) or scan plane obliquity secondary to a tortuous M1 segment of the MCA or an MCA ostium lesion or angled lesion (n = 35). Of 44 patients in the final analysis, negative remodeling was found in 19 (43.2%) lesions, and positive remodeling, in 25 (56.8%) lesions. At maximal lumen narrowing sites, lesions with negative remodeling had less vessel area, wall area, and percentage of plaque burden (P < .0001) and a lower eccentricity index (P = .023), compared with lesions with positive remodeling. The plaque involved the superior and dorsal walls in 15 (34.1%) of 44 patients.
  
  
  CONCLUSIONS
  2D high-resolution MR imaging can help assess the remodeling pattern and plaque distribution of MCA stenosis, but the imaging and postprocessing protocol for remodeling assessment needs to be improved in the tortuous course of the MCA and in MCA ostium or angled lesions.
authors: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: X J
authors: XJ
authors: Zhu
authors: B
authors: B
authors: Du
authors: X
authors: X
authors: Lou
authors: F K
authors: FK
authors: Hui
authors: L
authors: L
authors: Ma
authors: B W
authors: BW
authors: Zheng
authors: M
authors: M
authors: Jin
authors: C X
authors: CX
authors: Wang
authors: W-J
authors: WJ
authors: Jiang
mesh_terms: D000465:Algorithms; D050197:Atherosclerosis / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
references: Am J Cardiol. 1997 Oct 15;80(8):994-7
references: 9352966
references: Neurology. 2006 Jul 25;67(2):327-9
references: 16864831
references: Stroke. 2011 Jul;42(7):1971-5
references: 21636814
references: Stroke. 2012 Feb;43(2):616-20
references: 22246688
references: Stroke. 2012 Feb;43(2):580-4
references: 22246690
references: J Am Coll Cardiol. 2000 Nov 15;36(6):1860-9
references: 11092657
references: Neurology. 2010 Jul 20;75(3):253-8
references: 20644151
references: J Am Coll Cardiol. 2000 Jan;35(1):106-11
references: 10636267
references: Cerebrovasc Dis. 2009;27(5):433-42
references: 19295206
references: Cerebrovasc Dis. 2004;17(2-3):166-9
references: 14707417
references: J Cardiovasc Magn Reson. 2010 Jul 01;12:37
references: 20591197
references: J Neurointerv Surg. 2011 Dec 1;3(4):375-8
references: 21990448
references: Neurosurgery. 2012 Jan;70(1):25-30; discussion 31
references: 21795866
references: Radiology. 2008 Aug;248(2):550-60
references: 18574135
references: N Engl J Med. 2011 Sep 15;365(11):993-1003
references: 21899409
references: J Magn Reson Imaging. 2011 Jul;34(1):22-30
references: 21698704
references: Atherosclerosis. 2010 Oct;212(2):507-11
references: 20638663
references: Circulation. 2002 Feb 26;105(8):939-43
references: 11864922
references: Stroke. 2011 Oct;42(10):2957-9
references: 21799160