Abstract
Background:
Dolichoectasia (DE) of cerebral vessels has been associated with adverse neurological outcomes, including stroke. The subjectivity of the DE diagnosis is a limiting factor in the study of this condition. We examined arterial diameters of intracranial vessels in relation to a diagnosis of DE using standard criteria.
Methods:
The Northern Manhattan Study (NOMAS) is a multiethnic, community-based cohort of stroke-free participants. Participants who underwent head MRA were rated for the presence or absence of DE based on symmetry, parenchymal impingement, and Smoker criteria (posterior circulation). We used a semi-automated 3D tool to measure vessel lumen cross-sectional areas, and estimated artery diameters.
Results:
There were 718 NOMAS participants with MRA data available (mean age 72±8 years, 62% women, 56% Hispanic, 23% black, 18% white). Dolichoectasia was more frequent in the posterior circulation (25%), followed by the anterior circulation and both territories (12% for each). Diameters were obtained from 7,207 arteries. All dolichoectatic vessels had greater diameters compared to non-dolichoectatic vessels. Subjects with basilar artery DE had larger non-DE internal carotid artery diameters (at least 0.2 mm larger, P=0.003) but controlling for total cranial volume made this difference non-significant. The intra-rater reliability for visual DE ratings was poor to good (kappa=0.34-0.68) but reliability of vessel diameter measurements was excellent (intraclass correlations >0.85).
Conclusions:
The subjective attribution of DE corresponds with larger arterial diameters. Having DE in one artery seems to be associated with larger non-DE arteries. This is suggestive of a dilatatory propensity in patients with DE. Using arterial diameters appears to be reliable method to study this dilatatory arteriopathy.