Relationship between remodeling patterns and plaque enhancement in patients with symptomatic atherosclerotic middle cerebral artery stenosis

Abstract

Objective To investigate the relationship between vascular remodeling patterns of atherosclerotic middle cerebral artery (MCA) stenosis and plaque enhancement. Methods From August 2015 to June 2016, patients with unilateral symptomatic atherosclerotic MCA stenosis underwent routine MRI and black blood magnetic resonance imaging examinations. The vessel area and lumen area of MCA at the site of atherosclerotic MCA stenosis were measured, and the degree of MCA stenosis and the remodeling index were calculated. Results A total of 33 patients were included. Eleven had obvious plaque enhancement, including 9 positive remodeling and 2 negative remodeling; 22 did not have plaque enhancement, including 5 positive remodeling, 5 no remodeling, and 12 negative remodeling. The obvious plaque enhancement group was mainly positive remodeling (81.8% vs. 22.7%), and the no obvious enhancement group was mainly negative remodeling (54.5% vs. 18.2%). The difference was statistically significant (P=0.018). Conclusion Plaque enhancement at the site of atherosclerotic MCA stenosis is mainly positive remodeling, which reflects plaque instability. Key words: Stroke; Brain Ischemia; Atherosclerosis; Middle Cerebral Artery; Magnetic Resonance Imaging; Magnetic Resonance Angiography; Image Enhancement; Plaque, Atherosclerotic; Constriction, Pathologic