Basilar Artery Atherosclerotic Plaques in Paramedian and Lacunar Pontine Infarctions A High-Resolution MRI Study
Basilar Artery Atherosclerotic Plaques in Paramedian and Lacunar Pontine Infarctions A High-Resolution MRI Study
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DOI：
10.1161/strokeaha.110.583534
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发表时间：
2010-07-01
期刊：
影响因子：
8.3
通讯作者：
Amarenco, Pierre
中科院分区：
文献类型：
--
作者：
Klein, Isabelle F.;Lavallee, Philippa C.;Amarenco, Pierre
背景和目的：脑桥梗死最常与基底动脉粥样硬化相关，当病变邻接基底面时（旁正中脑桥梗死），而小的脑桥内侧病变通常归因于小血管脂透明质酸沉积。先前的一项研究发现，高分辨率MRI可以检测高达70%的旁正中桥脑梗死患者的基底动脉粥样硬化斑块，即使在血管造影正常的患者中，但没有人通过高分辨率MRI评估脑桥内侧小病变患者的基底动脉斑块的存在。飞行和对比增强的三维磁共振血管造影术，以评估基底动脉狭窄的存在和高分辨率磁共振成像，以评估动脉粥样硬化斑块的存在。基底动脉血管造影评分为“正常”、“不规则”或“狭窄”>= 30%”，高分辨率MRI的基底动脉评分为“正常”或“存在斑块”。结果：41例脑桥梗死患者，26例脑桥旁正中梗死，15例脑桥内侧小病变。高分辨率MRI在42%的脑桥梗死和基底动脉造影正常的患者中检测到基底动脉粥样硬化。在桥旁正中梗死患者中，65%的基底动脉造影正常，但77%的基底动脉粥样硬化高分辨率MRI检测。小脑桥内侧病变的患者中，46%有正常的基底动脉血管造影，但73%的基底动脉斑块检测上通过高分辨率MRI. conclusions-这项研究表明，脑桥内侧腔隙可能是由于继发于基底动脉粥样硬化的穿透性动脉疾病。高分辨率MRI可以帮助精确的中风亚型。（中风。2010;41：1405-1409.）
Background and Purpose-Pontine infarction is most often related to basilar artery atherosclerosis when the lesion abuts on the basal surface (paramedian pontine infarction), whereas small medial pontine lesion is usually attributed to small vessel lipohyalinosis. A previous study has found that high-resolution MRI can detect basilar atherosclerotic plaques in up to 70% of patient with paramedian pontine infarction, even in patients with normal angiograms, but none has evaluated the presence of basilar artery plaque by high-resolution MRI in patients with small medial pontine lesion in the medial part of the pons.Methods-Consecutive patients with pontine infarction underwent basilar angiography using time-of-flight and contrast-enhanced 3-dimensional MR angiography to assess the presence of basilar artery stenosis and high-resolution MRI to assess the presence of atherosclerotic plaque. Basilar artery angiogram was scored as "normal," "irregular," or "stenosed" >= 30%" and basilar artery by high-resolution MRI was scored as "normal" or "presence of plaque." Medial pontine infarcts were divided into paramedian pontine infarction and small medial pontine lesion groups.Results-Forty-one patients with pontine infarction were included, 26 with paramedian pontine infarction and 15 with small medial pontine lesion. High-resolution MRI detected basilar artery atherosclerosis in 42% of patients with a pontine infarction and normal basilar angiograms. Among patients with paramedian pontine infarction, 65% had normal basilar angiograms but 77% had basilar artery atherosclerosis detected on high-resolution MRI. Among patients with small medial pontine lesion, 46% had normal basilar angiograms but 73% had basilar artery plaques detected on by high-resolution MRI.Conclusions-This study suggests that medial pontine lacunes may be due to a penetrating artery disease secondary to basilar artery atherosclerosis. High-resolution MRI could help precise stroke subtyping. (Stroke. 2010;41:1405-1409.)