The location of basilar artery plaque combined with normal wall index can serve as a potential imaging marker for predicting posterior circulation ischemic stroke
ZHAO Shihua
LI Junlin
Abstract：Objective To assess the geometric morphology of the basilar artery and the characteristics of atherosclerotic plaques by using high-resolution magnetic resonance vessel wall imaging(HR-VWI),and analyze their correlation with posterior circulation ischemic stroke.Methods A retrospective analysis of 65 patients with basilar artery plaque who underwent high-resolution HR-VWI scanning was conducted.Patients with acute cerebral infarction(ACI)were divided into ACI group(n=30)and non-ACI(NACI)group according to DWI.The actual basilar artery length,linear length,and lateral BA-VA angle were measured in the infarction and NACI groups(n=35)using 3D-TOF-MRA reconstruction images.HR-VWI axial images were used to evaluate the distribution of basilar artery plaques in the two groups,measure and calculate the data related to plaque load and lumen stenosis rate in the two groups,compare the differences in the data between the two groups,and analyze the risk factors of posterior circulation stroke.Subsequently,the two groups were grouped according to the direction of basilar artery curvature to observe the difference of dominant vertebral artery between the two groups.Results Statistically significant differences were identified between the ACI and NACI groups with respect to hyperlipidemia,diabetes,midline angle in normal position,normalized wall index(NWI),and plaque location(P<0.05).After adjusting for confounding factors,NWI demonstrated a significant association with cerebral infarction(OR=1.11,95%CI:1.02-1.20,P=0.011);in contrast,the likelihood of causing cerebral infarction was found to be lower for plaques located in the dorsal and ventral walls compared to those in the lateral walls(OR=13.15,95%CI:3.15-54.92,P<0.001).Furthermore,the direction of basilar artery curvature was found to be associated with the dominant vertebral artery(P=0.009).Conclusion Hyperlipidemia,diabetes,and an increased mid-BA angle in the normal anatomical position can increase the risk of post erior circulation ischemic stroke.The location of plaque and NWI have been identified as independent predictors of cerebral infarction,and the integration of these two factors offers a more substantial diagnostic advantage for the evaluation of posterior circulation ischemic stroke.
Keywords：high-resolution magnetic resonance imaginggeometrical morphologybasilar arteryatherosclerotic plaqueposterior circulation stroke
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 574-581 )