ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1576655
This article is part of the Research TopicVascular Diseases of the Brain: Insights, Progress and Lessons LearnedView all 7 articles
Association of Carotid Artery Stenosis with Cerebral Artery Signal Intensity Gradient on Time-of-Flight Magnetic Resonance Angiography
Provisionally accepted
- 1Ulsan University Hospital, Ulsan, Republic of Korea
- 2MediIMG, Inc, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- 3Department of Mechanical Engineering, College of Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Daejeon, Republic of Korea
- 4Icahn School of Medicine at Mount Sinai, New York, New York, United States
- 5Department of Neurology, Asan Medical Center, Seoul, Republic of Korea
- 6Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
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Purpose: Extracranial internal carotid artery (ICA) stenosis is a known cause of large artery ischemic stroke. However, its association with cerebral arterial hemodynamics has been relatively underexplored. This study investigates the relationship between extracranial ICA stenosis and signal intensity gadient (SIG) in major cerebral arteries. The SIG is a surrogate marker for arterial wall shear rate. Methods: In the cross-sectional, retrospective study, we included individuals who underwent health screenings for vascular risk factors, as well as Time-of-Flight Magnetic Resonance Angiography and carotid Doppler ultrasonography. Extracranial ICA stenosis was categorized into three groups: normal, <50% stenosis, and ≥50% stenosis. In each group, SIGs were measured in major cerebral arteries. The association between ICA status and SIG in major cerebral arteries was analyzed using logistic regression, with SIG tertiles as the variable of interest. Results: A total of 1,138 individuals (mean age ± SD, 63.3±9.6 years) were included. ICA stenosis ≥50% was significantly associated with cerebral artery SIGs, with age and basilar artery (BA) SIG showing the strongest correlations. Multinomial logistic regression revealed that individuals in the lowest tertile of BA SIG had a significantly higher odds ratio (OR) for ICA stenosis (OR: 2.72, 95% CI: 1.27-5.82; p=0.010) compared to those in the highest tertile. Conclusion: ICA stenosis is significantly correlated with BA SIG, indicating a possibility of link between ICA stenosis and intracranial hemodynamics. A prospective longitudinal study is warranted to clarify the causal link between ICA stenosis and BA SIG.
Keywords: Basilar Artery, Internal Carotid Artery Stenosis, Signal intensity gradient, Time-offlight magnetic resonance angiography, Wall shear rate
Received: 28 Feb 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Lee, Jeong, Kim, Rosenson, Yang and Jung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Keun Hwa Jung, Department of Neurology, Seoul National University Hospital, Seoul, 03080, Republic of Korea
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