Morphologic characteristics of severe basilar artery atherosclerotic stenosis on 3D high-resolution MRI
Morphologic characteristics of severe basilar artery atherosclerotic stenosis on 3D high-resolution MRI
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基底动脉严重粥样硬化性狭窄的3D高分辨率MRI形态特征
DOI：
10.1186/s12883-018-1214-1
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发表时间：
2018-12-15
期刊：
影响因子：
2.6
通讯作者：
Xie, Sheng
中科院分区：
文献类型：
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作者：
Guo, Runcai;Zhang, Xuebin;Xie, Sheng
背景二维高分辨率MRI（2D HRMRI）在评价基底动脉固有迂曲的形态学特征方面面临着许多技术挑战。我们的目的是探讨重塑机制和斑块分布在有症状的患者与基底动脉狭窄的三维（3D）HRMRI. MethodsForty 6个连续的患者有症状的基底动脉粥样硬化性狭窄的MRA（70-99%）入选。重构指数（RI）是最大管腔狭窄（MLN）部位的血管面积与参考血管面积的比值。RI ≥ 1.05为正性重构（PR），RI ≤ 0.95为负性重构（NR），0.95 < RI < 1.05为中度重构（IR）。重构模式分为两组（PR和非PR [NR和IR]）。BA斑块的横截面和纵向分布进行了evaluated.Results2例患者被排除，因为质量差的图像。44例患者的图像可用于测量。PR 23例（52.3%），非PR 21例（47.7%）。在MLN部位，PR组的血管面积、壁面积、斑块大小和斑块负荷百分比显著大于非PR组（p<0.001）。44例患者中，大多数斑块（90.9%）位于背壁、左壁和右壁。斑块纵向分布：位于AICA近端BA 8个（18.2%），远端BA 36个（81.8%）。结论3D HRMRI结合后处理多平面重建技术可评价基底动脉粥样硬化性狭窄的重构模式和斑块分布，为颅内介入治疗提供依据。
BackgroundTwo-dimensional high-resolution MRI (2D HRMRI) faces many technical challenges for fully assessing morphologic characteristics of inherent tortuous basilar arteries. Our aim was to investigate remodeling mechanisms and plaque distribution in symptomatic patients with basilar artery stenosis on three-dimensional (3D) HRMRI.MethodsForty-six consecutive patients with symptomatic basilar artery atherosclerotic stenosis on MRA (70–99%) were enrolled. The remodeling index (RI) was the ratio of vessel area at the maximal-lumen-narrowing (MLN) site to reference vessel area. RI ≥ 1.05 was defined as positive remodeling (PR), RI ≤ 0.95 as negative remodeling (NR), and 0.95 < RI < 1.05 as intermediate remodeling (IR). The remodeling patterns were divided into two groups (PR and non-PR [NR and IR]). The cross-sectional and longitudinal distribution of BA plaques were evaluated.ResultsTwo patients were excluded because of poor-quality images. Images of 44 patients were available for measurements. PR was found in 23 (52.3%) patients, and non-PR in 21 (47.7%) patients. At the MLN sites, vessel area, wall area, plaque size and percentage of plaque burden of PR group were significantly greater than non-PR group (p< .001). Most plaques (90.9%) of the 44 patients were located at the dorsal, left and right walls. For the longitudinal distribution of plaque, 8 (18.2%) and 36 (81.8%) plaques were located in BA proximal and distal to AICA, respectively. Most plaques (68.2%) were eccentrically distributed.Conclusions3D HRMRI with postprocessing multiple planar reconstruction is able to evaluate the remodeling pattern and plaque distribution of basilar artery atherosclerotic stenosis, which might be used to guide intracranial intervention.