Basilar artery atherosclerotic plaques distribution in symptomatic patients: A 3.0 T high-resolution MRI study

PurposeTo investigate basilar artery atherosclerotic plaque distribution characteristics in symptomatic patients using 3.0 T high-resolution MRI.Materials and methodsThirty-eight patients with recent ischemic strokes or transient ischemic attacks were included. Conventional angiographic luminal imaging of these patients showed at least 30% basilar artery stenosis. Patients then underwent basilar artery high-resolution MRI examinations (T2WI, T1WI and post-contrast enhanced T1WI in short axial and long axial views). The narrowest lumen plaque distribution was evaluated by cross-section division into four equal arcs (right, ventral, left and dorsal arcs) on the short axial T2-weighted images. The percent plaque fraction was calculated as arc plaque area/luminal area × 100, with each compared by analysis.ResultsThe basilar artery lumens and walls were clearly shown in all 38 patients. The median plaque area sizes were 2.73 mm2 (range: 1.04–5.29 mm2) on the ventral wall, 0.59 mm2 (range: 0–1.50 mm2) on the left wall, 0.87 mm2 (range: 0–2.68 mm2) on the dorsal wall, and 0.36 mm2 (range: 0–1.80 mm2) on the right wall. The mean plaque fraction percentages were 21.6% (range: 7.9–34.0%) on the ventral wall, 4.6% (range: 0–10.0%) on the left wall, 6.3% (range: 0–16.3%) on the dorsal wall, and 2.6% (range: 0–12.9%) on the right wall. On the ventral wall, the plaque fraction percentage was significantly greater than the remaining three arcs (P = .000).ConclusionsBasilar artery atherosclerotic plaques were mainly distributed at the ventral site of the artery. High-resolution MR examination may provide helpful information to minimize endovascular therapy risk complications in basilar artery atherosclerotic disease.