Plaque Distribution And Arterial Remodeling Of Asymptomatic Basilar Atherosclerosis

Objective: Plaque distribution and arterial remodeling of asymptomatic basilar atherosclerosis remain unclear.We aimed to explore these characteristics by 3-dimensional high-resolution MRI(3D HR-MRI).Methods: We retrospectively analyzed patients from the HR-MRI database of Peking Union Medical College Hospital(from August,2014 to December,2016)?3D CUBE T1 WI was used to evaluate plaque and vessel wall characteristics,including plaque distribution,Fried-Breadstick Sign and plaque composition.We also measured vessel area,lumen area,maximal wall thickness,and basilar artery diameter both at plaque sites and reference sites.Results: Forty-six patients were enrolled as asymptomatic basilar atherosclerotic group,while fifty-five patients as control group in our study.Firstly,the most severe plaque region of asymptomatic basilar atherosclerotic plaques was mainly situated at lateral walls(66.7%),and most of them involved two or more quadrants(91.8%).Longitudinally,plaques were more frequently observed to form at basilar artery segment distal to anterior inferior cerebellar artery(AICA)(71.4%).Secondly,negative remodeling was more frequently observed in asymptomatic basilar atherosclerosis plaques(55.1%).There was only one patient whose basilar artery had plaques with both negative remodeling and positive remodeling.Compared with positive remodeling group,negative remodeling group often contain larger stenosis degree(p<0.01),lower prevalence of Fried-Breadstick Sign(p=0.045),smaller remodeling ratio,vessel area,lumen area,wall area,and basilar artery diameter(p<0.01;p<0.01;p=0.021;p<0.01;p=0.001).Thirdly,as to vessel area,lumen area,and basilar artery diameter,there was no significant difference between asymptomatic basilar atherosclerotic group(at reference sites)and control group(p=0.416;p=0.083;p=0.252),and asymptomatic basilar atherosclerotic group contain lower prevalence of Fried-Breadstick Sign than control group(p=0.041).Conclusions: In asymptomatic basilar atherosclerosis patients,the most severe region of plaques was mainly situated at lateral walls and plaques tend to affect basilar artery distal to AICA.Negative remodeling was frequently observed in asymptomatic basilar plaques.In patients with asymptomatic basilar atherosclerosis,general remodeling of basilar artery at non-plaque sites didn't exist.Analyzing basilar plaque distribution and remodeling mode by 3D HR-MRI would be helpful for uncovering the development of intracranial atherosclerosis and evaluating risks of ischemic stroke.