title: Plaque distribution of low-grade basilar artery atherosclerosis and its clinical relevance.
abstract: BACKGROUND
  The underlying pathophysiology of BA distribution is unclear and intriguing. Using high-resolution magnetic resonance imaging (HR-MRI), we sought to explore the plaque distribution of low-grade basilar artery (BA) atherosclerosis and its clinical relevance.
  
  
  METHODS
  We retrospectively analyzed the imaging and clinical data of 61 patients with low-grade atherosclerotic BA stenosis (<50%). On HR-MRI, the plaques were categorized based on the involvement of the ventral, dorsal, or lateral sides of BA wall. A culprit plaque was defined if it was on the same slice or neighboring slices of symptomatic pontine infarcts and played a probable causal role (dorsal plaques with median pontine infarcts or lateral plaques with ipsilateral pontine infarcts). The relationships between plaque distribution and clinical presentations were analyzed.
  
  
  RESULTS
  Twenty-five symptomatic and thirty-six asymptomatic BAs with 752 HR-MRI image slices were studied. The average length of BA atherosclerosis plaques was 12.16 ± 5.61mm (10.30 ± 6.44mm in symptomatic and 13.46 ± 7.03mm in asymptomatic patients, p = 0.079). The plaque distribution was similar at ventral (29.0%), dorsal (37.6%) and lateral walls (33.1%). The BA plaques in symptomatic patients were more frequently located at the dorsal (42.5%) and lateral (41.2%) walls than at the ventral walls (16.1%; P < 0.05). Compared with symptomatic patients, asymptomatic patients more likely had their plaques distributed at the ventral walls (P = 0.022). Culprit plaques were observed in 85.0% (17/20) pontine infarcts in symptomatic patients and only 14.3% (2/14) silent pontine infarcts in asymptomatic patients (p < 0.001).
  
  
  CONCLUSIONS
  Low-grade BA atherosclerosis has a long distribution and evenly involves ventral, dorsal and lateral walls. The plaques at dorsal and lateral walls are associated with symptomatic pontine infarcts but not with silent infarcts.
authors.affiliation: Department of Neurology and Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan1, Dongcheng District, Beijing, 100730, China.|Department of Neurology and Radiology, General Hospital of Chinese People's Armed Police Force, Beijing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Neurology and Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan1, Dongcheng District, Beijing, 100730, China.
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Li
authors.affiliation: Department of Neurology and Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan1, Dongcheng District, Beijing, 100730, China.
authors.forename: Yu-Yuan
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Department of Neurology and Radiology, General Hospital of Chinese People's Armed Police Force, Beijing, China.
authors.forename: Shi-Wen
authors.initials: SW
authors.lastname: Wu
authors.affiliation: Department of Neurology, Zhejiang University 2nd affiliate hospital, Hangzhou Shi, Zhejiang Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Lou
authors.affiliation: Department of Neurology and Radiology, General Hospital of Chinese People's Armed Police Force, Beijing, China.
authors.forename: Xue-Tao
authors.initials: XT
authors.lastname: Mu
authors.affiliation: Department of Neurology and Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan1, Dongcheng District, Beijing, 100730, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Feng
authors.affiliation: Department of Neurology and Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan1, Dongcheng District, Beijing, 100730, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Neurology and Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan1, Dongcheng District, Beijing, 100730, China. xuwh@pumch.cn.
authors.forename: Wei-Hai
authors.initials: WH
authors.lastname: Xu
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology*; D011149:Pons / Q000473:pathology; D012189:Retrospective Studies; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Clinical research; Intracranial atherosclerosis; Magnetic resonance imaging; Plaque