Arterial remodeling in middle cerebral artery atherosclerotic stenosis:a high-resolution MRI study

Abstract

To investigate remodeling mode of moderate or severe atherosclerotic stenosis of the middle cerebral artery (MCA) using high resolution MRI. Thirty-seven consecutive symptomatic patients with atherosclerotic MCA stenosis were imaged with a 3.0-T magnetic resonance scanner. The HR-MRI protocol included four different scans: T1-weighted black blood imaging, T2-weighted MR, proton density (PD)-weighted MR, and 3D-SPACE. The wall area (VA), lumen area (LA) and plaque area (PA) were calculated. The characterization of the plaque on HR-MRI was analysed. And the difference between positive remodeling (PR) and non-postive remodeling (non-PR) was explored. Thirty-four patients imaging was appropriate for analyse. Positive remodeling was found in 19 lesions. Compared with the non-PR group, the PR group had greater WA [(10.9 ± 2.5) mm² and (9.2 ± 1.9) mm², P = 0.039)] and greater PA [(6.4 ± 1.9) mm² and (3.9 ± 1.1) mm², P = 0]. High intensity on DWI and irregularity of plaque surface were more frequently observed in PR than non-PR. In patients with MCA atherosclerosis, PR lesions contain larger plaques than non-PR lesions and are probably with high risk for plaque rupture and subsequent stroke.