Dolichoectasia diagnostic methods in a multi-ethnic, stroke-free cohort: results from the northern Manhattan study

Dolichoectasia (DE) is a vasculopathy that consists of abnormal elongation and dilatation of arteries. The objective of this study is to evaluate the frequency of DE in an unselected population and assess different diagnostic methods.

The Northern Manhattan Study is a multiethnic population based cohort of stroke-free participants. The definition proposed for DE was total cranial volume (TCV)-adjusted arterial diameter ≥2 SD. Other methods studied included visual assessment, unadjusted arterial diameters cutoff, Smoker's criteria and basilar artery (BA) volume.

A total of 718 subjects were included in the analysis (mean age 71.6 ± 8.0 years, 40% men, 61% Hispanic). Using the TCV-adjusted DE definition, 19% of the sample had at least one dolichoectatic artery. In 7% of the subjects, two or more arteries were affected. The BA was the most common dolichoectatic artery. Reproducibility for arterial diameter measurements was good to excellent (.70-.95), while for visual assessment ranged from fair to good (.49-.79).

A TCV-adjusted intracranial arterial diameter ≥2 SD is proposed as a useful DE definition. The variability in the prevalence of DE depending on the methods used underscores the need to agree on a reliable, universal definition of DE.