Abstract
PURPOSE: This study aimed to compare differences in cerebrovascular luminal diameter (LD) and maximum wall thickness (MWT) among normal weight, overweight, and obese populations using three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR-VWI), and to evaluate the impact of body mass index (BMI, kg/m(2)) on cerebrovascular structure. PATIENTS AND METHODS: Ninety-six subjects were categorized into normal weight, overweight, and obesity groups according to Chinese criteria. Two radiologists with more than five years of experience independently and blindly measured LD, MWT, and vessel wall status of the bilateral internal carotid artery (ICA) segments C1-C7 and the middle cerebral artery (MCA) M1 segments. Differences in LD, MWT, and vessel wall status among the three groups were analyzed. RESULTS: The right C3 segment LD in the overweight group was significantly larger than in the normal weight group (overweight: 4.245 ± 0.199 mm vs normal weight: 3.676 ± 0.412 mm (right); p < 0.01), while the obese group showed retraction (obesity: 3.969 ± 0.714 mm (right), p < 0.01). MWT increased significantly with higher BMI (Z=10.99, χ (2) = 122.89, P < 0.001), with the most pronounced thickening in left C1, C2, and C6 segments in the obese group (H=19.806, 14.327, 21.732, P < 0.001). Each BMI increase (normal weight → overweight → obesity) raised the risk of vessel wall deterioration by 98% (OR=1.98, 95% CI: 1.75-2.24, P < 0.001). CONCLUSION: 3D HRMR-VWI revealed segment-specific remodeling in obese individuals, confirming a dose-effect relationship between elevated BMI and vessel wall deterioration. This provides a basis for optimizing 3D HRMR-VWI screening (focusing on high-risk segments) and establishing BMI-stratified intervention thresholds.