Objective To investigate the properties and remodeling pattern of basilar artery atherosclerosis
in paramedian pontine infarction (PPI) with 3.0T high-resolution magnetic resonance imaging
(HRMRI).
Methods Thirty consecutive patients with acute paramedian pontine infarction were enrolled from
January 2011 to December 2012, all are detected by conventional magnetic resonance imaging (MRI)
and magnetic resonance angiography (MRA), and HRMRI was performed on the target segment
by using a 3.0T MR scanner. Remodeling index (RI) was calculated as vessel area at maximal
lumen narrowing (MLN)/reference vessel area. RI ≤0.95 was defined as negative remodeling (NR),
0.95﹤RI ﹤1.05 as intermediate remodeling (IR), and RI ≥1.05 as positive remodeling (PR), wall
characteristics were compared between the NR and PR group.
Results In 30 patients, 9 arteries were shown stenosis, 21 arteries were shown normal on MRA,
while HRMRI detected 25 arteries with plaque, and the basilar artery (BA) plaques at or near
the origin of the penetrating artery. Analyze the 25 patients, NR was found in 8 patients, IR in 6
patients, and PR in 11 patients. At MLN sites, compared with lesions with NR, lesions with PR
had greater plaque area ([8.17±4.7]mm2 vs [1.08±1.89]mm2, P ﹤0.01), and a greater percent plaque
burden ([29.07±15.03]% vs [3.96±6.76]%, P ﹤0.01).
Conclusion HRMRI can help assess subtypes of ischemic stroke and the remodeling pattern of BA atherosclerosis. Etiology of PPI is the BA plaque blocking the penetrating artery. In patients with
PPI, NR and PR lesions are some frequently observed, and PR lesions have a greater wall area and
plaque burden than NR lesions.
