HR-MRI findings of intracranial artery stenosis and distribution of atherosclerotic plaques caused by different etiologies | springermedizin.de

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Neurological Sciences

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26.05.2022 | Original Article

HR-MRI findings of intracranial artery stenosis and distribution of atherosclerotic plaques caused by different etiologies

verfasst von: Jie Sun, Xu-Ran Feng, Ping-Yong Feng, Yu-Bo Liu, Hai-Xiao Yang, Xuan Yang, Tian-Zi Zhang

Erschienen in: Neurological Sciences | Ausgabe 9/2022

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Abstract

Objective

To investigate the etiology of intracranial artery stenosis and the distribution characteristics of intracranial artery atherosclerotic stenosis using high-resolution magnetic resonance imaging (HR-MRI).

Methods

A total of 262 patients with intracranial artery stenosis that underwent HR-MRI from November 2019 to December 2020 were retrospectively enrolled. The etiology of intracranial anterior and posterior circulation artery stenosis was analyzed, and the relationship between the location of plaques and the distribution characteristics of plaques and the occurrence of ischemic stroke was summarized.

Results

A total of 276 plaques were identified with HR-MRI. There were 101 cases (36.59%) in the middle cerebral artery (MCA), 14 cases (5.07%) in the posterior cerebral artery (PCA), 90 cases (32.62%) in vertebral artery (VA), and 71 cases (25.72%) in the basilar artery (BA). The infarct rate of ventral and superior wall MCA plaques was higher than that of dorsal and inferior wall (63.33% vs 31.25% P = 0.021) (100.00% vs 50% P = 0.022). MCA with plaques throughout the course had the greatest degree of stenosis (P < 0.001). Sphenoid segment (M1) of MCA was most susceptible (85 cases, 84.16%), MCA plaques were most common in the proximal M1 segment (35 cases, 34.65%), and most BA plaques were found in the distal segment (28 cases, 39.44%). PCA plaques were most frequently involved in traffic anterior segment (P1) (7 cases, 50.00%).

Conclusion

HR-MRI could provide accurate imaging reference for clinical evaluation of intracranial arterial stenosis and formulation of treatment plans. The intracranial arterial plates mostly appeared in the middle cerebral artery and vertebral artery. Middle cerebral arteries with atherosclerotic plaques are more likely to narrow.

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1.

Yaghi S, Prabhakaran S, Khatri P, Liebeskind DS (2019) Intracranial atherosclerotic disease. Stroke 50:1286–1293. https://doi.org/10.1161/STROKEAHA.118.024147CrossRefPubMed

2.

Gorelick PB, Wong KS, Bae HJ, Pandey DK (2008) Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke 39:2396–2399. https://doi.org/10.1161/STROKEAHA.107.505776CrossRefPubMed

3.

Flusty B, de Havenon A, Prabhakaran S, Liebeskind DS, Yaghi S (2020) Intracranial atherosclerosis treatment: past, present, and future. Stroke 51(3):e49–e53. https://doi.org/10.1161/STROKEAHA.119.028528CrossRefPubMedPubMedCentral

4.

Nordmeyer H, Chapot R, Haage P (2019) Endovascular treatment of intracranial atherosclerotic stenosis. Endovaskuläre Behandlung intrakranieller arteriosklerotischer Stenosen. Rofo 191(7):643–652. https://doi.org/10.1055/a-0855-4298CrossRefPubMed

5.

Holmstedt CA, Turan TN, Chimowitz MI (2013) Atherosclerotic intracranial arterial stenosis: risk factors, diagnosis, and treatment. Lancet Neurol 12(11):1106–1114. https://doi.org/10.1016/S1474-4422(13)70195-9CrossRefPubMedPubMedCentral

6.

Edjlali M, Qiao Y, Boulouis G et al (2020) Vessel wall MR imaging for the detection of intracranial inflammatory vasculopathies. Cardiovasc Diagn Ther 10(4):1108–1119. https://doi.org/10.21037/cdt-20-324CrossRefPubMedPubMedCentral

7.

Ran Y, Wang Y, Zhu M et al (2020) Higher plaque burden of middle cerebral artery is associated with recurrent ischemic stroke: a quantitative magnetic resonance imaging study. Stroke 51(2):659–662. https://doi.org/10.1161/STROKEAHA.119.028405CrossRefPubMed

8.

Xu WH, Li ML, Gao S et al (2011) Plaque distribution of stenotic middle cerebral artery and its clinical relevance. Stroke 42(10):2957–2959. https://doi.org/10.1161/STROKEAHA.111.618132CrossRefPubMed

9.

Swartz RH, Bhuta SS, Farb RI et al (2009) Intracranial arterial wall imaging using high-resolution 3-tesla contrast-enhanced MRI. Neurology 72(7):627–634. https://doi.org/10.1212/01.wnl.0000342470.69739.b3CrossRefPubMed

10.

Turan TN, LeMatty T, Martin R et al (2015) Characterization of intracranial atherosclerotic stenosis using high-resolution MRI study–rationale and design. Brain Behav 5(12):e00397. https://doi.org/10.1002/brb3.397CrossRefPubMedPubMedCentral

11.

Mandell DM, Mossa-Basha M, Qiao Y, Vessel Wall Imaging Study Group of the American Society of Neuroradiology et al (2017) Intracranial vessel wall MRI: principles and expert consensus recommendations of the American Society of Neuroradiology. AJNR Am J Neuroradiol 38(2):218–229. https://doi.org/10.3174/ajnr.A4893CrossRefPubMedPubMedCentral

12.

Wang Y, Zhao X, Liu L et al (2014) Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China: the Chinese Intracranial Atherosclerosis (CICAS) study. Stroke 45(3):663–669. https://doi.org/10.1161/STROKEAHA.113.003508CrossRefPubMed

13.

Ahn SH, Lee J, Kim YJ et al (2015) Isolated MCA disease in patients without significant atherosclerotic risk factors: a high-resolution magnetic resonance imaging study. Stroke 46(3):697–703. https://doi.org/10.1161/STROKEAHA.114.008181CrossRefPubMed

14.

Faraci FM, Heistad DD (1990) Regulation of large cerebral arteries and cerebral microvascular pressure. Circ Res 66(1):8–17. https://doi.org/10.1161/01.res.66.1.8CrossRefPubMed

15.

Leng X, Lan L, Ip HL et al (2019) Hemodynamics and stroke risk in intracranial atherosclerotic disease. Ann Neurol 85(5):752–764. https://doi.org/10.1002/ana.25456CrossRefPubMed

16.

Qiao Y, Anwar Z, Intrapiromkul J et al (2016) Patterns and implications of intracranial arterial remodeling in stroke patients. Stroke 47(2):434–440. https://doi.org/10.1161/STROKEAHA.115.009955CrossRefPubMedPubMedCentral

17.

López-Cancio E, Galán A, Dorado L et al (2012) Biological signatures of asymptomatic extra- and intracranial atherosclerosis: the Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) study. Stroke 43(10):2712–2719. https://doi.org/10.1161/STROKEAHA.112.661702CrossRefPubMed

18.

Cao YM, Zhang X, Wan X et al (2014) Relationship between sex and symptomatic intracranial atherosclerotic stenosis. Chin J Geriatr Heart Brain Vessel Dis 16(1):62–65. https://doi.org/10.3969/j.issn.1009-0126.2014.01.017CrossRef

19.

Huang HW, Guo MH, Lin RJ et al (2007) Prevalence and risk factors of middle cerebral artery stenosis in asymptomatic residents in Rongqi County, Guangdong. Cerebrovasc Dis 24(1):111–115. https://doi.org/10.1159/000103125CrossRefPubMed

20.

Kim YS, Kim BJ, Noh KC et al (2019) Distal versus proximal middle cerebral artery occlusion: different mechanisms. Cerebrovasc Dis 47(5–6):238–244. https://doi.org/10.1159/000500947CrossRefPubMed

21.

Wong KS, Gao S, Chan YL et al (2002) Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis: a diffusion-weighted imaging and microemboli monitoring study. Ann Neurol 52(1):74–81. https://doi.org/10.1002/ana.10250CrossRefPubMed

22.

Banerjee C, Chimowitz MI (2017) Stroke caused by atherosclerosis of the major intracranial arteries. Circ Res 120:502–513. https://doi.org/10.1161/CIRCRESAHA.116.308441CrossRefPubMedPubMedCentral

23.

Petrone L, Nannoni S, Del Bene A et al (2016) Branch atheromatous disease: a clinically meaningful, yet unproven concept. Cerebrovasc Dis 41(1–2):87–95. https://doi.org/10.1159/000442577CrossRefPubMed

24.

Jiang S, Yan Y, Yang T et al (2020) Plaque distribution correlates with morphology of lenticulostriate arteries in single subcortical infarctions. Stroke 51(9):2801–2809. https://doi.org/10.1161/STROKEAHA.120.030215CrossRefPubMedPubMedCentral

25.

Li J, Zheng L, Yang WJ et al (2021) Plaque wall distribution pattern of the atherosclerotic middle cerebral artery associates with the circle of Willis completeness. Front Neurol 11:599459. https://doi.org/10.3389/fneur.2020.599459CrossRefPubMedPubMedCentral

26.

Yu YN, Li ML, Xu YY et al (2018) Middle cerebral artery geometric features are associated with plaque distribution and stroke. Neurology 91(19):e1760–e1769. https://doi.org/10.1212/WNL.0000000000006468CrossRefPubMed

27.

Woo HG, Heo SH, Kim EJ et al (2020) Atherosclerotic plaque locations may be related to different ischemic lesion patterns. BMC Neurol 20(1):288. https://doi.org/10.1186/s12883-020-01868-0CrossRefPubMedPubMedCentral

28.

Lu M, Cui Y, Peng P et al (2019) Shape and location of carotid atherosclerotic plaque and intraplaque hemorrhage: a high-resolution magnetic resonance imaging study. J Atheroscler Thromb 26(8):720–727. https://doi.org/10.5551/jat.47449CrossRefPubMedPubMedCentral

29.

Ha SH, Chang JY, Lee SH et al (2021) Mechanism of stroke according to the severity and location of atherosclerotic middle cerebral artery disease. J Stroke Cerebrovasc Dis 30(2):105503. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105503CrossRefPubMed

30.

Chimowitz MI, Lynn MJ, Howlett-Smith H et al (2005) Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 352(13):1305–1316. https://doi.org/10.1056/NEJMoa043033CrossRefPubMed

31.

Barnard ZR, Alexander MJ (2019) Update in the treatment of intracranial atherosclerotic disease. Stroke Vasc Neurol 5(1):59–64. https://doi.org/10.1136/svn-2019-000279CrossRefPubMedPubMedCentral

32.

Seyedsaadat SM, Yolcu YU, Neuhaus A et al (2020) Submaximal angioplasty in the treatment of patients with symptomatic ICAD: a systematic review and meta-analysis. J Neurointerv Surg 12(4):380–385. https://doi.org/10.1136/neurintsurg-2019-015451CrossRefPubMed

33.

Flusty B, de Havenon A, Prabhakaran S et al (2020) Intracranial atherosclerosis treatment: past, present, and future. Stroke 51(3):e49–e53. https://doi.org/10.1161/STROKEAHA.119.028528CrossRefPubMedPubMedCentral

34.

Almallouhi E, Al Kasab S, Yamada L et al (2020) Relationship between vascular risk factors and location of intracranial atherosclerosis in the SAMMPRIS trial. J Stroke Cerebrovasc Dis 29(5):104713. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104713CrossRefPubMedPubMedCentral

Titel: HR-MRI findings of intracranial artery stenosis and distribution of atherosclerotic plaques caused by different etiologies
verfasst von: Jie Sun
Xu-Ran Feng
Ping-Yong Feng
Yu-Bo Liu
Hai-Xiao Yang
Xuan Yang
Tian-Zi Zhang
Publikationsdatum: 26.05.2022
Verlag: Springer International Publishing
Erschienen in: Neurological Sciences / Ausgabe 9/2022
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-06132-6

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