Atherosclerotic middle cerebral artery stenosis: adjacent arterial geometry, hemodynamics and plaque features

@article{liu2026atherosclerotic,
  title = {{Atherosclerotic middle cerebral artery stenosis: adjacent arterial geometry, hemodynamics and plaque features}},
  author = {Yu Liu and Shuang Li and Yue Gu and Xuan Tian and Yuying Liu and Ziqi Li and Yinhei Li and Tingjun Liang and Haipeng Liu and Linfang Lan and Bonaventure Y. M. Ip and Jingwei Li and Hui Fang and Bo Song and Yuming Xu and Thomas W. H. Leung and Jia Liu and Xinyi Leng},
  journal = {Japanese Journal of Radiology},
  year = {2026},
  month = jul,
  doi = {10.1007/s11604-026-02041-2},
  url = {https://doi.org/10.1007/s11604-026-02041-2},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Atherosclerotic middle cerebral artery stenosis: adjacent arterial geometry, hemodynamics and plaque features
AU  - Yu Liu
AU  - Shuang Li
AU  - Yue Gu
AU  - Xuan Tian
AU  - Yuying Liu
AU  - Ziqi Li
AU  - Yinhei Li
AU  - Tingjun Liang
AU  - Haipeng Liu
AU  - Linfang Lan
AU  - Bonaventure Y. M. Ip
AU  - Jingwei Li
AU  - Hui Fang
AU  - Bo Song
AU  - Yuming Xu
AU  - Thomas W. H. Leung
AU  - Jia Liu
AU  - Xinyi Leng
PY  - 2026
DA  - 2026/07/04
JO  - Japanese Journal of Radiology
DO  - 10.1007/s11604-026-02041-2
UR  - https://doi.org/10.1007/s11604-026-02041-2
AB  - Background: Adjacent vessel geometry may affect focal hemodynamics and plaque features in intracranial atherosclerotic disease.  Purpose: To investigate the correlations of upstream (internal carotid artery (ICA) bifurcation) and focal arterial geometry of M1 middle cerebral artery (MCA-M1) with location of MCA-M1 plaques and focal hemodynamics, particularly wall shear stress (WSS) metrics.  Methods: In patients with symptomatic atherosclerotic stenosis (50–99%) of MCA-M1, we assessed vessel geometry at ICA bifurcation and MCA-M1, including diameters and diameter ratios of different arterial segments, angles between arteries, and MCA-M1 tortuosity. The MCA-M1 plaque was defined as in proximal or distal halves of MCA-M1. Computational fluid dynamics (CFD) modeling was conducted to simulate adjacent blood flow and quantify relative wall shear stress (relative WSS, rWSS) across the MCA-M1 plaque (as relative to mean WSS at proximal normal segment). We investigated the associations of vessel geometry with the plaque location and rWSS metrics.  Results: Among 132 patients (median age 62 years), smaller diameter of MCA-M1 origin (adjusted odds ratio = 0.19, 95%CI 0.08–0.43, p < 0.001), smaller diameter ratio of MCA-M1 origin and terminal (0.04, 0.01–0.17, p < 0.001), and larger MCA-M1 tortuosity (1.03, 1.00–1.05, p = 0.045) were associated with proximal (versus distal) MCA-M1 plaques, independent of patient characteristics. These geometric parameters were associated with higher rWSS and larger area of high-rWSS region, throughout the MCA-M1 plaque and in upstream and downstream plaque segments, in patients with proximal MCA-M1 plaques (most p < 0.05), but not in those with distal MCA-M1 plaques. CFD models also revealed different velocity profiles and flow patterns in cases with different ICA bifurcation and MCA-M1 geometry.  Conclusions: Adjacent arterial geometry may affect plaque distribution in MCA-M1. Focal hemodynamics e.g., WSS and velocity profiles, may play a role underlying the associations.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11604-026-02041-2.
SN  - 1867-1071
SN  - 1867-108X
ER  -