Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Eur J Radiol. 2023 Sep;166:110971. doi: 10.1016/j.ejrad.2023.110971. Epub 2023 Jul 11.
To elucidate the vessel wall changes of vertebrobasilar dolichoectasia (VBD) with ischemic stroke, using vessel wall magnetic resonance imaging (VW-MRI).
Thirty-four patients with VBD (22 with stroke and 12 without stroke) who underwent VW-MRI were recruited. Forty-one patients without VBD who underwent VW-MRI were also recruited if they had a recent stroke due to atherosclerosis in the basilar artery or the intracranial vertebral artery. The vessel wall features of VBD were compared between stroke and non-stroke groups. The plaque characteristics were compared between VBD and non-VBD stroke patients.
The frequency of plaques was higher (54.5% vs. 8.3%, P = 0.011) in VBD patients with stroke than that in non-stroke patients, while the frequencies of aneurysm, dissection, intraluminal thrombus, and diffuse/concentric wall enhancement did not differ. When the plaque features were compared between plaque-positive stroke patients with and without VBD, the degree of stenosis (31.0% ± 26.8% vs. 71.5% ± 19.0%, P < 0.001), normalized wall index (NWI) (0.7 ± 0.1 vs. 0.9 ± 0.1, P < 0.001), and remodeling index (RI) (1.0 ± 0.4 vs. 1.3 ± 0.4, P = 0.023) were lower in the VBD group, while intraplaque hemorrhage, and enhancement ratio showed no difference.
This preliminary study suggests that atherosclerosis may be an important cause of stroke in VBD patients. Symptomatic plaques in VBD patients have a lower degree of stenosis, NWI, and RI than that in non-VBD patients. VW-MRI may help to assess stroke mechanisms and identify VBD patients at high risk.
使用血管壁磁共振成像（VW-MRI）阐明伴有缺血性脑卒中的椎基底动脉延长扩张症（VBD）的血管壁变化。
招募了 34 例 VBD 患者（22 例伴脑卒中，12 例无脑卒中）进行 VW-MRI 检查。如果基底动脉或颅内椎动脉粥样硬化导致近期脑卒中，还招募了 41 例无 VBD 的患者进行 VW-MRI 检查。比较 VBD 伴脑卒中组和无脑卒中组的血管壁特征。比较 VBD 和非 VBD 脑卒中患者的斑块特征。
VBD 伴脑卒中患者的斑块发生率较高（54.5% vs. 8.3%，P=0.011），而非脑卒中患者的发生率较低，而动脉瘤、夹层、腔内血栓和弥漫/同心壁增强的发生率无差异。当比较 VBD 阳性脑卒中患者和非 VBD 阳性脑卒中患者的斑块特征时，VBD 组的狭窄程度（31.0%±26.8% vs. 71.5%±19.0%，P<0.001）、归一化壁指数（NWI）（0.7±0.1 vs. 0.9±0.1，P<0.001）和重塑指数（RI）（1.0±0.4 vs. 1.3±0.4，P=0.023）较低，而斑块内出血和增强比无差异。
本初步研究表明，动脉粥样硬化可能是 VBD 患者脑卒中的重要原因。VBD 患者的症状性斑块狭窄程度、NWI 和 RI 低于非 VBD 患者。VW-MRI 可能有助于评估脑卒中机制，并识别高风险的 VBD 患者。
