High-resolution MRI of the vessel wall in patients with symptomatic atherosclerotic stenosis of the middle cerebral artery.
Intracranial atherosclerosis is associated with recurrent ischemic stroke. High-resolution MRI (HR MRI) can provide information about atheroma in vivo. We aimed to analyze and compare vascular wall imaging characteristics between patients with symptomatic and asymptomatic atherosclerotic stenosis of the middle cerebral artery (MCA) using 3.0 Tesla HR MRI. The HR MRI protocol included four different scans: black blood T1-weighted, T2-weighted and proton density-weighted MRI, as well as three-dimensional turbo spin echo imaging techniques with multiplanar reconstruction. Plaque characteristics, including location, morphology, and signal intensity, were analyzed in 51 patients (29 symptomatic, 22 asymptomatic) with atherosclerotic stenosis of the middle cerebral artery. The vessel wall area, lumen area, and plaque area (PA) were also calculated and compared between the symptomatic and asymptomatic groups. We found that PA, remodeling index (RI), and positive remodeling (PR) prevalence were significantly greater in the symptomatic group than in the asymptomatic group (PA: p=0.033; RI: p=0.020; PR: p=0.032). Plaque location in the superior aspect of the vessel wall and irregular plaque surface were more frequently observed in the symptomatic group than in the asymptomatic group (superior location: p=0.031; irregular surface: p=0.036). Moreover, multivariate logistic regression identified plaque location on the superior wall as an independent predictor of symptomatic MCA stenosis (odds ratio: 4.471; p=0.039). Therefore, we can conclude that patients with symptomatic atherosclerotic stenosis of the MCA are more likely to have larger plaques, PR, superiorly located plaques, and irregular plaque surface. These characteristics are promising factors for stratifying stroke risk.
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China.
Deng-Ling
DL
Zhao
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China.
Gang
G
Deng
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China.
Bo
B
Xie
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China.
Shenghong
S
Ju
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China.
Ming
M
Yang
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China.
Xiao-Hui
XH
Chen
Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, Jiangsu Province, China. Electronic address: gjteng@vip.sina.com.
Gao-Jun
GJ
Teng
D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002537:Intracranial Arteriosclerosis / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D015588:Observer Variation; D058226:Plaque, Atherosclerotic / Q000473:pathology; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis
Atherosclerosis; Magnetic resonance imaging; Middle cerebral artery; Remodeling