Plaque distribution of low-grade basilar artery atherosclerosis and its clinical relevance.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968555 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2377 (Electronic) Linking ISSN: 14712377 NLM ISO Abbreviation: BMC Neurol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Atherosclerosis/*pathology ; Basilar Artery/*pathology ; Plaque, Atherosclerotic/*pathology ; Vertebrobasilar Insufficiency/*pathology; Aged ; Atherosclerosis/diagnostic imaging ; Basilar Artery/diagnostic imaging ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Plaque, Atherosclerotic/diagnostic imaging ; Pons/pathology ; Retrospective Studies ; Vertebrobasilar Insufficiency/diagnostic imaging

Background: The underlying pathophysiology of BA distribution is unclear and intriguing. Using high-resolution magnetic resonance imaging (HR-MRI), we sought to explore the plaque distribution of low-grade basilar artery (BA) atherosclerosis and its clinical relevance.
Methods: We retrospectively analyzed the imaging and clinical data of 61 patients with low-grade atherosclerotic BA stenosis (<50%). On HR-MRI, the plaques were categorized based on the involvement of the ventral, dorsal, or lateral sides of BA wall. A culprit plaque was defined if it was on the same slice or neighboring slices of symptomatic pontine infarcts and played a probable causal role (dorsal plaques with median pontine infarcts or lateral plaques with ipsilateral pontine infarcts). The relationships between plaque distribution and clinical presentations were analyzed.
Results: Twenty-five symptomatic and thirty-six asymptomatic BAs with 752 HR-MRI image slices were studied. The average length of BA atherosclerosis plaques was 12.16 ± 5.61mm (10.30 ± 6.44mm in symptomatic and 13.46 ± 7.03mm in asymptomatic patients, p = 0.079). The plaque distribution was similar at ventral (29.0%), dorsal (37.6%) and lateral walls (33.1%). The BA plaques in symptomatic patients were more frequently located at the dorsal (42.5%) and lateral (41.2%) walls than at the ventral walls (16.1%; P < 0.05). Compared with symptomatic patients, asymptomatic patients more likely had their plaques distributed at the ventral walls (P = 0.022). Culprit plaques were observed in 85.0% (17/20) pontine infarcts in symptomatic patients and only 14.3% (2/14) silent pontine infarcts in asymptomatic patients (p < 0.001).
Conclusions: Low-grade BA atherosclerosis has a long distribution and evenly involves ventral, dorsal and lateral walls. The plaques at dorsal and lateral walls are associated with symptomatic pontine infarcts but not with silent infarcts.

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Keywords: Clinical research; Intracranial atherosclerosis; Magnetic resonance imaging; Plaque

Date Created: 20170111 Date Completed: 20170227 Latest Revision: 20181202

20240829

PMC5223551

10.1186/s12883-016-0785-y

28068949