Basilar artery features in two different mechanisms of acute isolated pontine infarct: a high-resolution magnetic resonance imaging study / 中华神经医学杂志

ABSTRACT

Objective:To investigate the high resolution vessel wall imaging (HR-VWI) features of basilar artery (BA) in patients with acute isolated pontine infarction (AIPI) of different infarct types, and explore the pathogenesis of AIPI.Methods:A retrospective analysis of clinical and imaging data of 52 patients with AIPI admitted to our hospital from June 2016 to November 2019 was performed. According to the morphology and location distribution of pontine high-signal lesions in diffusion-weighted imaging (DWI), these patients were divided into paramedian pontine infarction (PPI) group and small deep pontine infarction (SDPI) group. The general clinical data, modified National Institute of Health stroke scale (mNIHSS) scores at admission and discharge, modified Rankin scale (mRS) scores, and incidence of basilar artery plaques and plaque characteristics of basal artery in HR-VWI of patients from the two groups were compared.Results:Among the 52 AIPI patients, there were 28 patients with PPI (54%) and 24 with SDPI (46%). The mNIHSS scores at admission and discharge in the PPI group were significantly higher than those in the SDPI group ( P<0.05). The incidence of basilar artery plaques in PPI group was significantly higher than that in SDPI group (92.9% vs. 62.5%, P<0.05). As compared with SDPI group, PPI group had a significantly higher incidence of right lateral wall plaques, a statistically lower incidence of ventral wall plaques, and a significantly higher incidence of centripetal plaques, and significantly increased maximum thickness of vessel wall ( P<0.05). Conclusion:The AIPI mechanism is generally related to the branch atheromatous disease of basilar artery; PPI patients have more severe clinical symptoms, more serious clogged perforation opening of the basilar artery plaque, more unstable basilar artery plaque than the SDPI group.