title: Atherosclerotic plaque burden of middle cerebral artery and extracranial carotid artery characterized by MRI in patients with acute ischemic stroke in China: association and clinical relevance.
abstract: OBJECTIVE
  This study sought to compare the atherosclerotic plaque burden between middle cerebral artery (MCA) and extracranial carotid artery (ECA) in ischemic stroke patients using high-resolution, black-blood (HR BB) MRI and to investigate the relationship between plaque burden found in both arteries and stroke severity.
  
  
  METHODS
  All subjects with recent ischemic stroke underwent MCA and ECA HR BB MRI at 3.0 Tesla. For each artery segment, the thickness, area and signal intensities of plaques were recorded. Plaque burden, as measured by normalized wall index (NWI = wall area/total vessel area × 100%) were calculated. All patients received a clinical stroke severity score as measured by the National Institutes of Health Stroke Scale (NIHSS) scores at the time of admission.
  
  
  RESULTS
  A total of 65 stroke subjects were included in the final analysis. MCA exhibited significantly greater NWI than the ipsilateral ECA (symptomatic MCA vs. ECA: 58.04 ± 8.19 vs. 37.53 ± 10.25, p < 0.001; asymptomatic MCA vs. ECA: 53.80 ± 4.49 vs. 34.85 ± 4.27, p < 0.001, respectively). NWI in symptomatic MCA and ECA were significantly associated with NIHSS scores (r = 0.779 vs. 0.645; p < 0.001 respectively). Moreover, stronger statistical correlations between NIHSS scores and NWI were found in MCA, as compared with ECA during multivariate linear regression analysis.
  
  
  CONCLUSIONS
  Greater atherosclerotic plaque burden and a closer association with stroke severity were found for the MCA as compared to the ipsilateral ECA. Identification of MCA plaque lesions by MRI may be helpful for developing more aggressive strategies for stroke prevention.
authors.affiliation: a Department of Radiology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Cao
authors.affiliation: a Department of Radiology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.affiliation: a Department of Radiology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhou
authors.affiliation: a Department of Radiology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Huilin
authors.initials: H
authors.lastname: Zhao
authors.affiliation: b Department of Neurology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: a Department of Radiology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Xu
authors.affiliation: a Department of Radiology , Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Liu
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Atherosclerosis; extracranial carotid artery; magnetic resonance imaging; middle cerebral artery; plaque burden