title: Evaluation of basilar artery atherosclerotic plaque distribution by 3D MR vessel wall imaging.
abstract: Basilar artery (BA) atherosclerosis is an important cause of perforator stroke in the brainstem due to plaque involvement of the perforator ostia in BA dorsal or lateral walls. Therefore, to acquire information on plaque distribution is important to better understand and prevent the perforator stroke. This study aimed to comprehensively evaluate BA plaque distribution with 3D magnetic resonance imaging (MRI) vessel wall imaging.
  
  
  
  Consecutive patients with cerebrovascular symptoms and stenosis or irregular luminal surface of BA were recruited and underwent BA 3D proton density-weighted volume isotropic turbo spin echo acquisition (VISTA) imaging at 3T. The cross-sectional and longitudinal distribution of BA plaque were analyzed with a custom-developed tool.
  
  
  
  In all, 85 BA plaques were detected in 61 recruited patients. For cross-sectional distribution, the prevalence of plaque involvement in the ventral, left, dorsal, and right quadrant of BA wall was 74.1%, 70.6%, 67.1%, and 62.4%, respectively. Of the 85 plaques, 17.7% involved one quadrant and 82.3% involved two or more quadrants. The most severe plaque region was more commonly situated at lateral walls (66.1%) as compared to ventral (23.2%, P < 0.001) and dorsal walls (10.6%, P < 0.001). Longitudinally, plaques were more frequently found to occur at BA segment distal than proximal to anterior inferior cerebellar artery (AICA) (63.5% vs. 36.5%).
  
  
  
  Taking advantage of 3D MR vessel wall imaging, BA plaques were found to more likely affect lateral walls and form in BA distal to AICA, where most perforators originate, suggesting that it might be useful to characterize BA plaque distribution before aggressive treatment for prevention of perforator stroke. J. Magn. Reson. Imaging 2016;44:1592-1599.
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Zhensen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: New Era Stroke Care and Research Institute, General Hospital of the PLA Rocket Force, Beijing, China.
authors.forename: Ao-Fei
authors.initials: AF
authors.lastname: Liu
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Huijun
authors.initials: H
authors.lastname: Chen
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.|Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Le
authors.initials: L
authors.lastname: He
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Yandong
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Yangzhou First People's Hospital, Yangzhou, China.
authors.forename: Maobin
authors.initials: M
authors.lastname: Guan
authors.affiliation: New Era Stroke Care and Research Institute, General Hospital of the PLA Rocket Force, Beijing, China.
authors.forename: Wei-Jian
authors.initials: WJ
authors.lastname: Jiang
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Xihai
authors.initials: X
authors.lastname: Zhao
mesh_terms: D001488:Basilar Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: basilar artery; magnetic resonance imaging; perforator stroke; plaque distribution; three-dimensional