Fig. 2.

Negative remodeling. A patient (56–60 years) with hypertension, diabetes mellitus and hyperlipidemia presented with left limb weakness for 4 days. Coronal reconstruction image a revealed the plaque in BA distal to AICA. The line 1 represents the distal reference site; line 2, maximal-lumen-narrowing (MLN) site; line 3, proximal reference site. Cross-sectional images at the distal, MLN and proximal sites were shown in Figs. b, c and d respectively, as shown by the arrow. The plaque was located in BA distal to AICA. The VA is 18.17 mm² at MLN site, 17.29 mm² at distal site, and 23.44 mm² at proximal site. The reference VA is 20.37 mm². The remodeling index (RI) at the MLN site was 0.89 (RI ≤ 0.95, defined as negative remodeling). The LA is 0.37 mm² at MLN site, 5.85 mm² at distal site, and 7.48 mm² at proximal site. The reference LA is 6.67 mm². The WA is 17.8 mm² at MLN site, and 13.7 mm² at reference site. So the plaque size is 4.1 mm². The maximal wall thickness is 3.2 mm, and the minimal wall thickness is 0.8 mm. The eccentricity index is 0.75, and percentage of plaque burden is 22.6%. Compared with the case above (Fig. 1), this one had smaller VA, WA, plaque size and percentage of plaque burden