Vascular Morphology has No Direct Relationship with Atherosclerotic Plaque Burden in Patients with Symptomatic Middle Cerebral Artery Stenosis

Author(s): Lu Liu, Chengju Huo, Hao Sun, Hua Yang, Rui Zhang, Lexin Wang*, Zhangyong Xia*.

Journal Name: Current Neurovascular Research

Volume 16 , Issue 3 , 2019

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Abstract:

Background: The vascular morphology and the characteristics of atherosclerotic plaques in the middle cerebral artery (MCA) have not been fully studied with high-resolution magnetic resonance imaging (HR-MRI).

Objective: HR-MRI was applied to investigate vascular morphology and atherosclerotic plaque in patients with symptomatic MCA stenosis.

Materials and Methods: A total of 343 patients with symptomatic MCA stenosis were enrolled in this study. All the patients were examined by HR-MRI to analyze the morphology of MCA and the M1 segment (MCA-M1), the characteristics and the location of the plaques.

Results: The proportion of L-shaped MCA-M1 decreased, while the proportion of S-shaped MCAM1 increased with age. The anterior plaques were the most common in all the patients. The superior plaques were relatively common in patients with L-shaped and U-shaped MCA-M1, while the inferior plaques were relatively common in patients with inverted U-shaped and S-shaped MCAM1. Among all the plaques, the majority were isointense or heterogeneous. The MCA-M1 morphology had no direct relationship with the common risk factors of atherosclerosis and the clinical outcomes of the patients after 12 months of follow up.

Conclusion: The morphology of MCA-M1 is not directly related to the plaque burden or the degree of stenosis in patients with symptomatic MCA stenosis. The morphology of MCA-M1 is not associated with the risk factors of atherosclerosis, or the clinical outcomes of the patients.

Keywords: High-resolution magnetic resonance imaging, middle cerebral artery, vascular morphology, atherosclerotic plaque, stroke, cerebral artery stenosis.

[1]
Choi YJ, Jung SC, Lee DH. Vessel wall imaging of the intracranial and cervical carotid arteries. J Stroke 2015; 17(3): 238-55.
[2]
Xia ZY, Sun QJ, Yang H, et al. Effect of carotid artery stenting on cognitive function in patients with internal carotid artery stenosis and cerebral lacunar infarction: A 3-year follow-up study in China. PLoS One 2015; 10(6): e0129917.
[3]
Xia Z, Yang H, Yuan X, et al. High-resolution magnetic resonance imaging of carotid atherosclerotic plaques - a correlation study with histopathology. Vasa 2017; 46(4): 283-90.
[4]
de Havenon A, Mossa-Basha M, Shah L, et al. High-resolution vessel wall MRI for the evaluation of intracranial atherosclerotic disease. Neuroradiology 2017; 59(12): 1193-202.
[5]
Jauch EC, Saver JL, Adams HP Jr, et al. American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Peripheral Vascular Disease; Council on Clinical Cardiology. Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44(3): 870-947.
[6]
Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial investigators. Design, progress and challenges of a double-blind trial of warfarin versus aspirin for symptomatic intracranial arterial stenosis. Neuroepidemiology 2003; 22(2): 106-17.
[7]
Chen L, Zhan Q, Ma C, et al. Reproducibility of middle cerebral artery stenosis measurements by DSA: Comparison of the NASCET and WASID Methods. PLoS One 2015; 10(6): e0130991.
[8]
Lei C, Wu B, Liu M, Chen Y. Risk factors and clinical outcomes associated with intracranial and extracranial atherosclerotic stenosis acute ischemic stroke. J Stroke Cerebrovasc Dis 2014; 23(5): 1112-7.
[9]
Tavares CA, Rassi CH, Fahel MG, Wajchenberg BL, Rochitte CE, Lerario AC. Relationship between glycemic control and coronary artery disease severity, prevalence and plaque characteristics by computed tomography coronary angiography in asymptomatic type 2 diabetic patients. Int J Cardiovasc Imaging 2016; 32(10): 1577-85.
[10]
Liebeskind DS, Caplan LR. Intracranial arteries-anatomy and collaterals. Front Neurol Neurosci 2016; 40: 1-20.
[11]
Han J, Qiao H, Li X, et al. The three-dimensional shape analysis of the M1 segment of the middle cerebral artery using MRA at 3T. Neuroradiology 2014; 56(11): 995-1005.
[12]
Zurada A, Gielecki J, Tubbs RS, et al. Three-dimensional morphometrical analysis of the M1 segment of the middle cerebral artery: Potential clinical and neurosurgical implications. Clin Anat 2011; 24(1): 34-46.
[13]
Pedrigi RM, Mehta VV, Bovens SM, et al. Influence of shear stress magnitude and direction on atherosclerotic plaque composition. R Soc Open Sci 2016; 3(10): 160588.
[14]
Krishnan S, Otaki Y, Doris M, et al. Molecular imaging of vulnerable coronary plaque: A pathophysiologic perspective. J Nucl Med 2017; 58(3): 359-64.
[15]
Umansky F, Gomes FB, Dujovny M, et al. The perforating branches of the middle cerebral artery. A microanatomical study. J Neurosurg 1985; 62(2): 261-8.
[16]
Dieleman N, Yang W, Abrigo JM, et al. Magnetic resonance imaging of plaque morphology, burden, and distribution in patients with symptomatic middle cerebral artery stenosis. Stroke 2016; 47(7): 1797-802.
[17]
Kim BJ, Yoon Y, Lee DH, et al. The shape of middle cerebral artery and plaque location: High-resolution MRI finding. Int J Stroke 2015; 10(6): 856-60.
[18]
Choi YJ, Jung SC, Lee DH. Vessel Wall Imaging of the Intracranial and Cervical Carotid Arteries. J Stroke 2015; 17(3): 238-55.
[19]
den Hartog AG, Bovens SM, Koning W, et al. Current status of clinical magnetic resonance imaging for plaque characterisation in patients with carotid artery stenosis. Eur J Vasc Endovasc Surg 2013; 45(1): 7-21.
[20]
Cai Y, He L, Yuan C, et al. Atherosclerotic plaque features and distribution in bilateral carotid arteries of asymptomatic elderly population: A 3D multicontrast MR vessel wall imaging study. Eur J Radiol 2017; 96: 6-11.
[21]
Kim JM, Jung KH, Sohn CH, Moon J, Han MH, Roh JK. Middle cerebral artery plaque and prediction of the infarction pattern. Arch Neurol 2012; 69(11): 1470-5.
[22]
Kerwin WS, Miller Z, Yuan C. Imaging of the high-risk carotid plaque: Magnetic resonance imaging. Semin Vasc Surg 2017; 30(1): 54-61.
[23]
Chen XY, Wong KS, Lam WW, Ng HK. High signal on T1 sequence of magnetic resonance imaging confirmed to be intraplaque haemorrhage by histology in middle cerebral artery. Int J Stroke 2014; 9(4): E19.
[24]
Klein IF, Labreuche J, Lavallée PC, et al. Is moderate atherosclerotic stenosis in the middle cerebral artery a cause of or a coincidental finding in ischemic stroke? Cerebrovasc Dis 2010; 29(2): 140-5.
[25]
Degnan AJ, Gallagher G, Teng Z, Lu J, Liu Q, Gillard JH. MR angiography and imaging for the evaluation of middle cerebral artery atherosclerotic disease. AJNR Am J Neuroradiol 2012; 33(8): 1427-35.
[26]
Li F, Chen QX, Chen ZB, Tian DF, Cai Q. Magnetic resonance imaging of plaque burden in vascular walls of the middle cerebral artery correlates with cerebral infarction. Curr Neurovasc Res 2016; 13(4): 263-70.
[27]
Yamamoto S, Yamagami H, Todo K, et al. Correlation of middle cerebral artery tortuosity with successful recanalization using the Merci retrieval system with or without adjunctive treatments. Neurol Med Chir (Tokyo) 2014; 54(2): 113-9.
[28]
Xi HY, Si ZH, Li JC, Zhu JG, Yan HY. Assessment of cerebral infarction after transient cerebral ischemic attack by ABCD score combined with the position of intracranial vascular stenosis. Medicine (Baltimore) 2019; 98(15): e15081.
[29]
Chrencik MT, Khan AA, Luther L, et al. Quantitative assessment of carotid plaque morphology (geometry and tissue composition) using computed tomography angiography. J Vasc Surg 2019; pii: S0741-5214(19)30141-7.
[30]
Seiffge DJ, Curtze S, Dequatre-Ponchelle N, et al. Hematoma location and morphology of anticoagulation-associated intracerebral hemorrhage. Neurology 2019; 92: e782-91.


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Article Details

VOLUME: 16
ISSUE: 3
Year: 2019
Page: [224 - 231]
Pages: 8
DOI: 10.2174/1567202616666190618122746
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