Jinmei Zheng1, Bin Sun1, Ruolan Lin1, Yongqi Teng2, Xihai Zhao3, Yunjing Xue4. 1. Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. 2. Department of Radiology, Changle District Hospital of Fuzhou, Fuzhou, 350299, Fujian, China. 3. Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China. 4. Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. xueyunjing@126.com.
Abstract
BACKGROUND: Atherosclerotic plaques are often present in regions of arteries with complicated flow patterns. Vascular morphology plays important role in hemodynamics. In this study, we investigated the relationship between the geometry of the vertebrobasilar artery system and presence of basilar artery (BA) plaque. METHODS: We enrolled 290 patients with posterior circulation ischemic stroke. We distinguished four configurations of the vertebrobasilar artery: Walking, Tuning Fork, Lambda, and No Confluence. Patients were divided into multi-bending (≥ 3 bends) and oligo-bending (< 3 bends) VA groups. The diameter of the vertebral artery (VA) and the number of bends in the intracranial VA segment were assessed using three-dimensional time-of-flight magnetic resonance angiography. High-resolution magnetic resonance imaging was used to evaluate BA plaques. Logistic regression models were used to determine the relationship between the geometry type and BA plaque prevalence. RESULTS: After adjusting for sex, age, body mass index ≥ 28, hypertension, and diabetes mellitus, the Walking, Lambda, and No Confluence geometries were associated with the presence of BA plaque (all p < 0.05). Patients with multi-bending VAs in both the Walking (20/28, 71.43% vs. 6/21, 28.57%, p = 0.003) and Lambda group (19/47, 40.43% vs. 21/97, 21.65%, p = 0.018) had more plaques compared to patients with oligo-bending VAs in these groups. In the Lambda group, the difference in diameter of bilateral VAs was larger in patients with BA plaques than that in patients without BA plaques (1.4 mm [IQR: 0.9-1.6 mm] vs. 0.9 mm [IQR: 0.6-1.3 mm], p < 0.001). CONCLUSIONS: The Walking, Lambda, and No Confluence geometry, ≥ 3 bends in the VAs, and a large diameter difference between bilateral VAs are associated with the presence of BA plaque.
BACKGROUND: Atherosclerotic plaques are often present in regions of arteries with complicated flow patterns. Vascular morphology plays important role in hemodynamics. In this study, we investigated the relationship between the geometry of the vertebrobasilar artery system and presence of basilar artery (BA) plaque. METHODS: We enrolled 290 patients with posterior circulation ischemic stroke. We distinguished four configurations of the vertebrobasilar artery: Walking, Tuning Fork, Lambda, and No Confluence. Patients were divided into multi-bending (≥ 3 bends) and oligo-bending (< 3 bends) VA groups. The diameter of the vertebral artery (VA) and the number of bends in the intracranial VA segment were assessed using three-dimensional time-of-flight magnetic resonance angiography. High-resolution magnetic resonance imaging was used to evaluate BA plaques. Logistic regression models were used to determine the relationship between the geometry type and BA plaque prevalence. RESULTS: After adjusting for sex, age, body mass index ≥ 28, hypertension, and diabetes mellitus, the Walking, Lambda, and No Confluence geometries were associated with the presence of BA plaque (all p < 0.05). Patients with multi-bending VAs in both the Walking (20/28, 71.43% vs. 6/21, 28.57%, p = 0.003) and Lambda group (19/47, 40.43% vs. 21/97, 21.65%, p = 0.018) had more plaques compared to patients with oligo-bending VAs in these groups. In the Lambda group, the difference in diameter of bilateral VAs was larger in patients with BA plaques than that in patients without BA plaques (1.4 mm [IQR: 0.9-1.6 mm] vs. 0.9 mm [IQR: 0.6-1.3 mm], p < 0.001). CONCLUSIONS: The Walking, Lambda, and No Confluence geometry, ≥ 3 bends in the VAs, and a large diameter difference between bilateral VAs are associated with the presence of BA plaque.
Entities:
Keywords:
Atherosclerosis; Geometry; Intracranial artery; Magnetic resonance imaging; Vertebrobasilar
Authors: Sepideh Amin-Hanjani; Dilip K Pandey; Linda Rose-Finnell; Xinjian Du; DeJuran Richardson; Keith R Thulborn; Mitchell S V Elkind; Gregory J Zipfel; David S Liebeskind; Frank L Silver; Scott E Kasner; Victor A Aletich; Louis R Caplan; Colin P Derdeyn; Philip B Gorelick; Fady T Charbel Journal: JAMA Neurol Date: 2016-02 Impact factor: 18.302