Jia Li1, Lu Zheng2, Wen-Jie Yang3, Cheuk-Yin Sze-To4, Thomas Wai-Hong Leung5, Xiang-Yan Chen1. 1. Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong. 2. Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 3. The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, United States. 4. Department of Diagnostic and Interventional Radiology, The Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong. 5. Division of Neurology, Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Abstract
Objective: Investigating the relevance of the incomplete circle of Willis (COW) to the plaque wall distribution in the atherosclerotic middle cerebral arteries (MCAs) through utilizing high-resolution magnetic resonance imaging (HR-MRI), and its potential clinical impact. Methods: This hospital-based study enrolled consecutive adult patients with acute ischemic stroke or transient ischemic attack, who received a 3.0T Achieva MR system scanning. The COW completeness was evaluated on MR angiography imaging, including anterior (A) and posterior (P)-COW sections. The MCA plaque wall distribution was assessed on HR-MRI. The occurrence of perforator infarction was detected on diffusion-weighted imaging. Results: Among 87 patients (mean age = 62.39 ± 11.64 years old) with atherosclerotic plaques in the MCA M1 segments, the incomplete COW types were more prevalent than the complete COW type (incomplete P-COW, 83.9%; incomplete A-COW, 36.8%; complete COW, 8.1%). The incomplete A-COW had more inferior but fewer ventral plaques of MCA atherosclerosis than the complete A-COW, while the incomplete P-COW had fewer inferior MCA plaques than the complete P-COW. Moreover, symptomatic MCA plaques causing perforator infarctions were more likely to locate on the superior wall. Conclusion: Our findings suggested that the COW completeness could influence the vessel wall distribution of the MCA plaques, among which the superior plaques of symptomatic MCA atherosclerosis was associated with branch occlusive disease.
Objective: Investigating the relevance of the incomplete circle of Willis (COW) to the plaque wall distribution in the atherosclerotic middle cerebral arteries (MCAs) through utilizing high-resolution magnetic resonance imaging (HR-MRI), and its potential clinical impact. Methods: This hospital-based study enrolled consecutive adult patients with acute ischemic stroke or transient ischemic attack, who received a 3.0T Achieva MR system scanning. The COW completeness was evaluated on MR angiography imaging, including anterior (A) and posterior (P)-COW sections. The MCA plaque wall distribution was assessed on HR-MRI. The occurrence of perforator infarction was detected on diffusion-weighted imaging. Results: Among 87 patients (mean age = 62.39 ± 11.64 years old) with atherosclerotic plaques in the MCA M1 segments, the incomplete COW types were more prevalent than the complete COW type (incomplete P-COW, 83.9%; incomplete A-COW, 36.8%; complete COW, 8.1%). The incomplete A-COW had more inferior but fewer ventral plaques of MCA atherosclerosis than the complete A-COW, while the incomplete P-COW had fewer inferior MCA plaques than the complete P-COW. Moreover, symptomatic MCA plaques causing perforator infarctions were more likely to locate on the superior wall. Conclusion: Our findings suggested that the COW completeness could influence the vessel wall distribution of the MCA plaques, among which the superior plaques of symptomatic MCA atherosclerosis was associated with branch occlusive disease.
Authors: Péter Vince Banga; Andrea Varga; Csaba Csobay-Novák; Márton Kolossváry; Emese Szántó; Gustavo S Oderich; László Entz; Péter Sótonyi Journal: J Vasc Surg Date: 2018-07-06 Impact factor: 4.268
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