Association Between Basilar Artery Configuration and Vessel Wall Features: a Prospective High-resolution Magnetic Resonance Imaging Study

Overview

Journal BMC Med Imaging

Publisher Biomed Central

Specialty Radiology

Date 2019 Dec 28

PMID 31878890

Citations 4

Authors

Ziqi Xu

Mingyao Li

Zhikai Hou

Jinhao Lyu

Na Zhang

Xin Lou

Zhongrong Miao

Ning Ma

Affiliations

Soon will be listed here.

Abstract

Background: The relationship between intracranial vessel configuration and wall features remains poorly investigated. Therefore, we aimed to investigate the relationship between the distal and proximal anatomical configuration of basilar artery (BA) and BA vessel wall features on high-resolution magnetic resonance imaging (HRMRI).

Methods: From September 2014 to January 2017, patients with suspected symptomatic intracranial arterial stenosis underwent HRMRI. Patients with severe BA stenosis were selected for this prospective study and divided into two groups corresponding to complete and incomplete BA configuration based on characteristics of the bilateral vertebral arteries and posterior cerebral arteries. Culprit blood vessel wall features on HRMRI included plaque enhancement, intraplaque hemorrhage, remodeling patterns, and plaque distribution. Culprit vessel wall features were compared between patients in the complete and incomplete BA configuration groups.

Results: Among the 298 consecutively enrolled patients, 34 had severe BA stenosis. Twenty patients had complete anatomical BA configuration and another 14 of them displayed incomplete configuration. There were no significant differences in vessel wall features between the complete and incomplete configuration patient groups. However, the proximal configuration of BA was associated with intraplaque hemorrhage (p = 0.002) while the distal configuration of BA correlated with strong enhancement of BA plaque (p = 0.041).

Conclusions: No association was found between the complete and incomplete BA configuration groups and blood vessel wall features. The proximal configuration of BA was related with intraplaque hemorrhage and the distal configuration of BA was associated with strong plaque enhancement. Further studies are warranted to confirm these findings.

Trial Registration: URL: Unique identifier: NCT02705599 (March 10, 2016).

Citing Articles

Vessel wall MRI characteristics associated with intraprocedural stent thrombosis during angioplasty for intracranial atherosclerotic stenosis.

Ma X, Yan P, Ju J, Yang Z, Wang W, Wang Q J Neurointerv Surg. 2023; 16(12):1348-1352.

PMID: 37989580 PMC: 11672038. DOI: 10.1136/jnis-2023-020941.

Posterior Circulation ASPECTS on CT Angiography Predicts Futile Recanalization of Endovascular Thrombectomy for Acute Basilar Artery Occlusion.

Ouyang K, Kang Z, Liu Z, Hou B, Fang J, Xie Y Front Neurol. 2022; 13:831386.

PMID: 35370881 PMC: 8966670. DOI: 10.3389/fneur.2022.831386.

Vertebrobasilar Junction Angle Over 90°: A Potential Imaging Marker Associated With Vertebrobasilar Atherosclerosis.

Li J, Yang W, Zheng L, Du H, Chu W, Leung T Front Neurosci. 2022; 15:789852.

PMID: 35069103 PMC: 8766791. DOI: 10.3389/fnins.2021.789852.

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

Sun J, Liu G, Zhang D, Wu Z, Liu J, Wang W J Atheroscler Thromb. 2021; 28(12):1333-1339.

PMID: 33642443 PMC: 8629706. DOI: 10.5551/jat.62448.

References

Jeng J, Yip P . Evaluation of vertebral artery hypoplasia and asymmetry by color-coded duplex ultrasonography. Ultrasound Med Biol. 2004; 30(5):605-9. DOI: 10.1016/j.ultrasmedbio.2004.03.004. View

Han H . Twisted blood vessels: symptoms, etiology and biomechanical mechanisms. J Vasc Res. 2012; 49(3):185-97. PMC: 3369246. DOI: 10.1159/000335123. View

Xu W, Li M, Gao S, Ni J, Yao M, Zhou L . Middle cerebral artery intraplaque hemorrhage: prevalence and clinical relevance. Ann Neurol. 2012; 71(2):195-8. DOI: 10.1002/ana.22626. View

Amin-Hanjani S, Pandey D, Rose-Finnell L, Du X, Richardson D, Thulborn K . Effect of Hemodynamics on Stroke Risk in Symptomatic Atherosclerotic Vertebrobasilar Occlusive Disease. JAMA Neurol. 2016; 73(2):178-85. PMC: 5274634. DOI: 10.1001/jamaneurol.2015.3772. View

Kumar Arjal R, Zhu T, Zhou Y . The study of fetal-type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes. Clin Imaging. 2014; 38(3):221-5. DOI: 10.1016/j.clinimag.2014.01.007. View

Bodle J, Feldmann E, Swartz R, Rumboldt Z, Brown T, Turan T . High-resolution magnetic resonance imaging: an emerging tool for evaluating intracranial arterial disease. Stroke. 2012; 44(1):287-92. PMC: 3556720. DOI: 10.1161/STROKEAHA.112.664680. View

Holmstedt C, Turan T, Chimowitz M . Atherosclerotic intracranial arterial stenosis: risk factors, diagnosis, and treatment. Lancet Neurol. 2013; 12(11):1106-14. PMC: 4005874. DOI: 10.1016/S1474-4422(13)70195-9. View

Gulli G, Marquardt L, Rothwell P, Markus H . Stroke risk after posterior circulation stroke/transient ischemic attack and its relationship to site of vertebrobasilar stenosis: pooled data analysis from prospective studies. Stroke. 2013; 44(3):598-604. DOI: 10.1161/STROKEAHA.112.669929. View

Abuzinadah A, Alanazy M, Almekhlafi M, Duan Y, Zhu H, Mazighi M . Stroke recurrence rates among patients with symptomatic intracranial vertebrobasilar stenoses: systematic review and meta-analysis. J Neurointerv Surg. 2014; 8(2):112-6. PMC: 6310226. DOI: 10.1136/neurintsurg-2014-011458. View

10.

Tan I, Demchuk A, Hopyan J, Zhang L, Gladstone D, Wong K . CT angiography clot burden score and collateral score: correlation with clinical and radiologic outcomes in acute middle cerebral artery infarct. AJNR Am J Neuroradiol. 2009; 30(3):525-31. PMC: 7051470. DOI: 10.3174/ajnr.A1408. View

11.

Ma N, Xu Z, Lyu J, Li M, Hou Z, Liu Y . Association of Perforator Stroke After Basilar Artery Stenting With Negative Remodeling. Stroke. 2019; 50(3):745-749. DOI: 10.1161/STROKEAHA.118.023838. View

12.

Qiao Y, Anwar Z, Intrapiromkul J, Liu L, Zeiler S, Leigh R . Patterns and Implications of Intracranial Arterial Remodeling in Stroke Patients. Stroke. 2016; 47(2):434-40. PMC: 4729583. DOI: 10.1161/STROKEAHA.115.009955. View

13.

Chimowitz M, Kokkinos J, Strong J, Brown M, Levine S, Silliman S . The Warfarin-Aspirin Symptomatic Intracranial Disease Study. Neurology. 1995; 45(8):1488-93. DOI: 10.1212/wnl.45.8.1488. View

14.

Perren F, Poglia D, Landis T, Sztajzel R . Vertebral artery hypoplasia: a predisposing factor for posterior circulation stroke?. Neurology. 2007; 68(1):65-7. DOI: 10.1212/01.wnl.0000250258.76706.98. View

15.

Savitz S, Caplan L . Vertebrobasilar disease. N Engl J Med. 2005; 352(25):2618-26. DOI: 10.1056/NEJMra041544. View

16.

Yu J, Kwak H, Chung G, Hwang S, Park M, Park S . Association of Intraplaque Hemorrhage and Acute Infarction in Patients With Basilar Artery Plaque. Stroke. 2015; 46(10):2768-72. DOI: 10.1161/STROKEAHA.115.009412. View

17.

Ay H, Furie K, Singhal A, Smith W, Sorensen A, Koroshetz W . An evidence-based causative classification system for acute ischemic stroke. Ann Neurol. 2005; 58(5):688-97. DOI: 10.1002/ana.20617. View

18.

Ravensbergen J, Ravensbergen J, Krijger J, Hillen B, Hoogstraten H . Localizing role of hemodynamics in atherosclerosis in several human vertebrobasilar junction geometries. Arterioscler Thromb Vasc Biol. 1998; 18(5):708-16. DOI: 10.1161/01.atv.18.5.708. View

19.

Hong J, Chung C, Bang O, Yong S, Joo I, Huh K . Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts. J Neurol Neurosurg Psychiatry. 2009; 80(10):1087-92. PMC: 2735647. DOI: 10.1136/jnnp.2008.169805. View

20.

Ma N, Jiang W, Lou X, Ma L, DU B, Cai J . Arterial remodeling of advanced basilar atherosclerosis: a 3-tesla MRI study. Neurology. 2010; 75(3):253-8. DOI: 10.1212/WNL.0b013e3181e8e714. View