Association between basilar artery configuration and Vessel Wall features: a prospective high-resolution magnetic resonance imaging study

Ziqi Xu, Mingyao Li, Zhikai Hou, Jinhao Lyu, Na Zhang, Xin Lou, Zhongrong Miao, Ning Ma, Ziqi Xu, Mingyao Li, Zhikai Hou, Jinhao Lyu, Na Zhang, Xin Lou, Zhongrong Miao, Ning Ma

Abstract

Background: The relationship between intracranial vessel configuration and wall features remains poorly investigated. Therefore, we aimed to investigate the relationship between the distal and proximal anatomical configuration of basilar artery (BA) and BA vessel wall features on high-resolution magnetic resonance imaging (HRMRI).

Methods: From September 2014 to January 2017, patients with suspected symptomatic intracranial arterial stenosis underwent HRMRI. Patients with severe BA stenosis were selected for this prospective study and divided into two groups corresponding to complete and incomplete BA configuration based on characteristics of the bilateral vertebral arteries and posterior cerebral arteries. Culprit blood vessel wall features on HRMRI included plaque enhancement, intraplaque hemorrhage, remodeling patterns, and plaque distribution. Culprit vessel wall features were compared between patients in the complete and incomplete BA configuration groups.

Results: Among the 298 consecutively enrolled patients, 34 had severe BA stenosis. Twenty patients had complete anatomical BA configuration and another 14 of them displayed incomplete configuration. There were no significant differences in vessel wall features between the complete and incomplete configuration patient groups. However, the proximal configuration of BA was associated with intraplaque hemorrhage (p = 0.002) while the distal configuration of BA correlated with strong enhancement of BA plaque (p = 0.041).

Conclusions: No association was found between the complete and incomplete BA configuration groups and blood vessel wall features. The proximal configuration of BA was related with intraplaque hemorrhage and the distal configuration of BA was associated with strong plaque enhancement. Further studies are warranted to confirm these findings.

Trial registration: URL: Unique identifier: NCT02705599 (March 10, 2016).

Keywords: Anatomical configuration; Atherosclerotic disease; Collateral circulation; High-resolution MRI; Vertebrobasilar artery.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Example of complete and incomplete artery configuration of basilar artery. Case 1: the complete configuration of BA. a: the normal right VA with severe tortuosity of the first segment; b: normal left VA with severe stenosis of BA; c: HRMRI showing intraplaque hemorrhage of BA plaque on T1 weight imaging. Case 2: the incomplete distal configuration of BA. d: right VA angiography showing severe stenosis of BA without left PCA. e: left common carotid artery angiography showing fetal type PCA. f: HRMRI showing strong enhancement of BA plaque. Case 3: the incomplete proximal configuration of BA. G: dominant VA angiography showing severe stenosis of BA. H: CT angiography showing right VA hypoplasia. I: HRMRI showing intraplaque hemorrhage of BA plaque on T1 weight imaging
Fig. 2
Fig. 2
Flow chart of study

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