The Longitudinal Distribution and Stability of Curved Basilar Artery Plaque: A Study Based on HR-MRI

J Atheroscler Thromb. 2021 Dec 1;28(12):1333-1339. doi: 10.5551/jat.62448. Epub 2021 Feb 27.

Abstract

Aims: This study aims to evaluate the differences in the characteristics of atherosclerotic plaques in the proximal, curved, and distal segments of the curved basilar artery (BA) through high-resolution magnetic resonance imaging(HR-MRI).

Methods: The imaging and clinical data of 146 patients were retrospectively analyzed. On the basis of three-dimensional (3D) time -of -flight magnetic resonance angiography (3D-TOF-MRA), 51 patients with BA curvature were selected for the study. The BA plaque is divided into three groups: proximal, curved, and distal. Plaques were identified and analyzed according to spin echo acquisition imaging via T1-weighted 3D volumetric isotropic Tse acquisition (T1W-3D -VISTA), and compare the differences in clinical related factors and plaque characteristics between groups. Diffusion-weighted imaging (DWI) and/or T2WI identified brainstem infarction. The patients were divided into symptomatic and asymptomatic groups. The correlation between plaque location and symptoms was identified and analyzed.

Results: Among 51 patients, a total of 376 plaques were detected. Plaques in the proximal and curved segments are more common than those in the distal segments. Proximal plaques are more likely to have intraplaque hemorrhage ( P=0.002 <0.05). There was no significant difference in the distribution of criminal plaques and non-criminal plaques between each group (P=0.36 >0.05).

Conclusion: Plaques in the proximal and curved segments of the BA are more common than those in the distal segments. The proximal plaque is more prone to intraplaque hemorrhage.

Keywords: Basilar artery; High-resolution MRI; Plaque.

MeSH terms

  • Asymptomatic Diseases
  • Basilar Artery* / diagnostic imaging
  • Basilar Artery* / pathology
  • Brain Stem / blood supply
  • Brain Stem Infarctions / prevention & control
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Hemorrhage* / diagnostic imaging
  • Hemorrhage* / etiology
  • Humans
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic* / complications
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Plaque, Atherosclerotic* / pathology
  • Plaque, Atherosclerotic* / physiopathology
  • Symptom Assessment / methods