Article Figures & Data
Figures
- Fig 1.
Relationship between the ICA/CCA ratio and the clinical stage (Suzuki stage, I–VI [early–advanced]). A, The ICA/CCA ratio decreased as the clinical stage advanced, and the CBNS was observed in stage III or higher. B, The median ICA/CCA ratio, expressed as median (interquartile range) was 0.71 (0.60–0.77) in stages I and II, 0.49 (0.45–0.57) in stages III and IV, and 0.38 (0.34–0.47) in stages V and VI (P < .001). The ICA/CCA ratio was significantly lower in stages V and VI than in stages I and II.
- Fig 2.
Relationships between the ICA/CCA ratio and clinical symptoms. A, Symptomatic arteries were more frequently observed in the CBNS-positive group than in the CBNS-negative group (73% versus 33%, respectively; Fisher exact test, P = .06). B, The median ICA/CCA ratio in symptomatic arteries tended to be lower than that in asymptomatic arteries (0.47 [interquartile range: 0.40–0.53] versus 0.57 [0.47–0.66], respectively; P = .06).
- Fig 3.
Relationship between the ICA/CCA ratio and CVR to acetazolamide in the MCA territory. The CVR decreased as the ICA/CCA ratio decreased (R = 0.80, P < .01). Of 9 arteries with a CBNS, 8 (89%) exhibited a reduced CVR. Symptomatic arteries exhibited both the CBNS and a reduced CVR. Asterisk indicates symptomatic arteries.
- Fig 4.
Representative cases. The left, middle, and right columns show the features of carotid ultrasonography, a lateral view of DSA of the carotid and intracranial arteries, and an axial SPECT image from 3 cases: A, A 15-year-old girl had a Suzuki stage I artery on the right (asymptomatic) and a stage II artery on the left (symptomatic). The CBNS was negative on the right by carotid ultrasonography and DSA, with preserved CVR (arrows). B, A 37-year-old woman had a stage III artery on the right (symptomatic) and a stage IV artery on the left (asymptomatic). The CBNS was positive on the right, with a mildly decreased CVR (arrows). C, A 58-year-old woman had a stage II artery on the right (asymptomatic) and a stage VI artery on the left (symptomatic). The CBNS was positive on the left, with a markedly decreased CVR (arrows).
Tables
Patient characteristics
Characteristic Patients (no.) 14 Age (mean ± SD, range) (y) 43.2 ± 19.3, 6–71 Sex (no.) Male 5 Female 9 Clinical diagnoses at onset (no.) Hemorrhagic stroke 4 Ischemic stroke 5 Transient ischemic attack 4 Asymptomatic 1 Arteries (no.) 27 Suzuki grades (no. of arteries) Stage I 3 Stage II 2 Stage III 12 Stage IV 4 Stage V 3 Stage VI 3 Evaluation of ICA/CCA ratio (no. of arteries) Ultrasonography 20 DSA 7 CBNS (no. of arteries) Positive 15 Negative 12
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