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Articles
July 19, 2010

Arterial remodeling of advanced basilar atherosclerosis
A 3-tesla MRI study

July 20, 2010 issue
75 (3) 253-258

Abstract

Background: There are limited studies on wall imaging of human basilar artery (BA). Our aim was to investigate remodeling mode of advanced BA atherosclerosis using 3-T MRI.
Methods: Thirty-two consecutive symptomatic patients with atherosclerotic BA stenosis ≥70% were imaged with a 3-T magnetic resonance scanner. Proton density-weighted (PDW) cross-sectional images with submillimeter voxel size were obtained. The vessel area (VA) and lumen area (LA) at the maximal lumen narrowing (MLN) site and reference site were measured. Intraobserver and interobserver variability was determined by intraclass correlation coefficient (ICC). Wall area (WA) was estimated by VA − LA. Plaque size (PS) was estimated by WA at MLN site − reference WA. Percent plaque burden was calculated as (PS/VA at MLN site) × 100%. Remodeling index (RI) was the ratio of VA at MLN site to reference VA. RI ≥1.05 was defined as positive remodeling (PR) and RI <1.05 as non-PR.
Results: Measurements of cross-sectional BA images were available in 30 of 32 patients. Intraobserver or interobserver variability was small, with ICC ranging from 0.955 to 0.996. The mean RI of the 30 patients was 1.2 ± 0.4. PR was found in 19 (63.3%) patients and non-PR in 11 (36.7%) patients. Compared with the non-PR group, the PR group had greater PS (15.0 ± 9.3 mm2 vs 6.4 ± 3.9 mm2, p = 0.007) and greater percent plaque burden (50.5 ± 9.9% vs 28.5 ± 12.7%, p < 0.0001).
Conclusions: 3-T high-resolution PDW imaging is a reproducible tool for measuring BA dimensions. In patients with advanced BA atherosclerosis, PR lesions are more frequently observed and contain larger plaques than non-PR lesions.

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Information & Authors

Information

Published In

Neurology®
Volume 75Number 3July 20, 2010
Pages: 253-258
PubMed: 20644151

Publication History

Published online: July 19, 2010
Published in print: July 20, 2010

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Keyword

  1. BA = basilar artery; HRMRI = high-resolution MRI; ICC = intraclass correlation coefficient; IR = intermediate remodeling; LA = lumen area; MLN = maximal lumen narrowing; MR = magnetic resonance; NR = negative remodeling; PDW = proton density-weighted; PR = positive remodeling; PS = plaque size; RI = remodeling index; VA = vessel area; WA = wall area.

Authors

Affiliations & Disclosures

N. Ma, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.
W.J. Jiang, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.
X. Lou, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.
L. Ma, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.
B. Du, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.
J.F. Cai, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.
T.Q. Zhao, MD
From the Department of Interventional Neuroradiology (N.M., W.J.J., B.D., J.F.C.), Beijing Tiantan Hospital, Capital Medical University; and Department of Radiology (X.L., L.M., T.Q.Z.), People's Liberation Army (PLA) General Hospital, Beijing, China.

Notes

Address correspondence and reprint requests to Dr. Wei-Jian Jiang, Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Beijing, China 100050 [email protected]

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