Analysis of incidence and risk factors for progression in patients with intracranial steno-occlusive lesions by serial magnetic resonance angiography.

OBJECTIVES

Conventional angiography and transcranial Doppler ultrasonography have usually been used for serial observation of cerebral atherosclerotic diseases. This study used magnetic resonance (MR) angiography to monitor serial changes in steno-occlusive lesions of the major intracranial arteries to elucidate the incidence of progression and investigate the risk factors for progression.

PATIENTS AND

METHODS

The 151 consecutive patients, 78 males and 73 females aged 42-92 years (mean 71.1+/-10.2 years), were followed up by serial MR angiography for 5-34 months (mean 14.4+/-5.78 months). Progression was defined as increased stenosis or occlusion, or new stenotic lesion. Age, sex, duration of MR angiography follow up, hypertension, diabetes mellitus, hyperlipidemia, hyperuricemia, current smoking, and atrial fibrillation were chosen as risk factors for multiple logistic analysis.

RESULTS

Twenty-three of the patients (15.2%) had progression, caused by total occlusion in 10, increased stenosis in 10, and new stenosis in 3, 15 patients had regression, and 113 patients had no change. Diabetes (odds ratio: 6.771, p value: 0.0004) and current smoking (odds ratio: 7.574, p value: 0.0019) were determined as significant risk factors for progression.

CONCLUSIONS

Patients with intracranial steno-occlusive lesion and either diabetes or smoking habit should be carefully followed up by serial MR angiography.