Hemodynamic analysis of lenticulostriate artery dilation in MCA atherosclerotic stenosis
Chao Zhang1,2,3, Tong Chen4, Xun Pei1,2,3,5
1Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Objective:
To investigate the perfusion changes associated with lenticulostriate artery (LSA) dilation in patients with middle cerebral artery (MCA) atherosclerosis utilizing 7.0 T MRI and CT perfusion imaging (CTP).
Methods:
Forty-eight symptomatic atherosclerotic MCA plaques were analyzed. All patients underwent 7.0 T MRI and CTP examinations. LSA dilation was defined as a markedly enlarged vessel diameter comparable to that of MCA M3/M4 segments. The stenotic MCAs were divided into LSA dilation group (n = 21) and non-dilation group (n = 27). Plaque characteristics, LSA morphological features, and perfusion parameters in the LSA territory were assessed.
Results:
Compared with the non-dilation group, the LSA dilation group showed significantly higher cerebral blood flow/relative cerebral blood flow (CBF/rCBF) and cerebral blood volume (CBV), and a markedly prolonged mean transit time (MTT) in the LSA-supplied regions (all p < 0.05). The incidence of infarction, superior-wall plaque, and plaque involving the LSA origin was significantly higher in the LSA dilation group than in the non-dilation group (all p < 0.05).
Conclusion:
LSA dilation may indicate a compensatory vascular remodeling process, closely associated with plaque location. This phenomenon is accompanied by distinct hemodynamic alterations within its blood supply territory.
