High-resolution magnetic resonance imaging findings of basilar artery plaque in a patient with branch atheromatous disease: a case report.
High-resolution magnetic resonance imaging findings of basilar artery plaque in a patient with branch atheromatous disease: a case report.
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DOI：
10.1186/1752-1947-8-395
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发表时间：
2014-11-29
影响因子：
1
通讯作者：
Tanaka F
中科院分区：
文献类型：
--
作者：
Miyaji Y;Kawabata Y;Joki H;Seki S;Mori K;Kamide T;Tamase A;Nomura M;Kitamura Y;Tanaka F
颅内分支动脉粥样硬化性疾病是一种缺血性中风，是由于动脉粥样硬化斑块使穿通动脉的开口变窄或闭塞而引起的。桥脑分支动脉粥样硬化性疾病通常通过间接检查来诊断，如病变延伸至脑桥基底面，因为难以显示基底动脉中的斑块。一位72岁的日本男性突然出现构音障碍和左侧轻偏瘫，此后症状恶化。脑磁共振成像显示在右侧旁正中桥脑动脉延伸至基底面的区域发生急性梗死。非对比增强三维快速自旋回波T1成像与可变翻转角和三维快速成像与稳态采集显示斑块的背壁基底动脉，蔓延到起源的旁正中脑桥动脉分支向梗死。虽然开始使用抗血栓药物，但左侧轻偏瘫恶化，并在第二天变得松弛。这是第一个报告，以确认病理基础的分支动脉粥样硬化性疾病的三维图像使用的新模式的3特斯拉磁共振成像。这些技术的应用将促进对分支动脉粥样硬化疾病的临床病理机制的更好理解。
Intracranial branch atheromatous disease is a type of ischemic stroke that is caused by narrowing or occlusion of the orifice of the penetrating artery by atheromatous plaque. Pontine branch atheromatous disease is usually diagnosed using indirect findings such as the extension of a lesion to the basal surface of the pons because of the difficulty of demonstrating plaque in the basilar artery. A 72-year-old Japanese man developed sudden dysarthria and left hemiparesis, and his symptoms deteriorated thereafter. Brain magnetic resonance imaging revealed an acute infarction in the territory of the right paramedian pontine artery extending to the basal surface. Non-contrast-enhanced three-dimensional fast spin-echo T1 imaging with variable flip angles and three-dimensional fast imaging with steady-state acquisition revealed a plaque in the dorsal wall of the basilar artery that spread to the origin of the paramedian pontine artery that branched toward the infarction. Although antithrombotic agents were started, the left hemiparesis got worse and became flaccid on the following day. This is the first report to confirm the pathological basis of branch atheromatous disease by three-dimensional images using the new modalities of 3-Tesla magnetic resonance imaging. The use of these techniques will foster better understanding of the clinicopathological mechanisms of branch atheromatous disease.