{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T13:56:17Z","timestamp":1781013377536,"version":"3.54.1"},"reference-count":42,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Young Scientists Fund of the Natural Science Foundation of Sichuan Province of China","award":["2024NSFSC1705"],"award-info":[{"award-number":["2024NSFSC1705"]}]},{"name":"Doctoral Scientific Research Foundation of North Sichuan Medical College","award":["CBY21-QD03"],"award-info":[{"award-number":["CBY21-QD03"]}]},{"name":"Fostering Distinguished Young Scholars","award":["CBY22-JQ02"],"award-info":[{"award-number":["CBY22-JQ02"]}]},{"name":"\u201cHongQi Research Fund\u201d science and technology project","award":["2019HQ-10"],"award-info":[{"award-number":["2019HQ-10"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Purpose<\/jats:title>\n               <jats:p>Few data are available on the causality of cerebral artery fenestration (CAF) triggering cerebral infarction (CI) and this study aims to identify representative morphological features that can indicate risks.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Methods<\/jats:title>\n               <jats:p>A cohort comprising 89 patients diagnosed with CAF were enrolled from a total of 9,986 cranial MR angiographies. These patients were categorized into Infarction Group (<jats:italic>n<\/jats:italic>\u00a0=\u00a055) and Control Group (<jats:italic>n<\/jats:italic>\u00a0=\u00a034) according to infarction events. These two groups are divided into two subgroups depending on fenestration location (basilar artery or other cerebravascular location), respectively, <jats:italic>i.e.<\/jats:italic>, BA Infarction Group (<jats:italic>n<\/jats:italic>\u00a0=\u00a037), BA Control Group (<jats:italic>n<\/jats:italic>\u00a0=\u00a023), Non_BA Infarction Group (<jats:italic>n<\/jats:italic>\u00a0=\u00a018), Non_BA Control Group (<jats:italic>n<\/jats:italic>\u00a0=\u00a011). This study firstly defined 12 indices to quantify the morphological characteristics of fenestration <jats:italic>per se<\/jats:italic> and its connecting arteries. The data were evaluated using either the independent sample <jats:italic>t<\/jats:italic>-test or the Mann\u2013Whitney U test. Conducting univariate and multivariate logistic regression analyses to ascertain potential independent predictors of CI.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>The initiation angle <jats:italic>\u03c6<\/jats:italic><jats:sub>1<\/jats:sub> and confluence angle <jats:italic>\u03c6<\/jats:italic><jats:sub>2<\/jats:sub> at the fenestration in the Infarction Group are both smaller compared to the Control Group, but only the Infarction Group and BA Infarction Group have significant difference (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). The maximum left fenestration axis (fA<jats:sub>L<\/jats:sub>) and the left tortuosity index (TI<jats:sub>L<\/jats:sub>) were greater in the Infarction Group for CAFs than those in the Control Group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). In contrast, the maximum right fenestration axis (fA<jats:sub>R<\/jats:sub>) and the right tortuosity index (TI<jats:sub>R<\/jats:sub>) were smaller than those in Control Group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). The logistic regression analysis revealed that <jats:italic>\u03c6<\/jats:italic><jats:sub>2<\/jats:sub> (AUC = 0.68, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), fA<jats:sub>L<\/jats:sub> (AUC = 0.72, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), and fA<jats:sub>R<\/jats:sub> (AUC = 0.70, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) serve as independent risk factors influencing the occurrence of CI. The regression predictive model achieved an AUC of 0.83, enabling accurate classification of 77.5% of cases, indicating a robust predictive performance of the model.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusion<\/jats:title>\n               <jats:p>Morphological results demonstrated a left-leaning type of fenestration with more narrow fenestration terminals indicating a higher risk of CI occurrence. Furthermore, the regression predictive model established in this study demonstrates a good predictive performance, enabling early prediction of CI occurrence in fenestrated patients and facilitating early diagnosis of CI.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.18774","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T08:27:42Z","timestamp":1737448062000},"page":"e18774","source":"Crossref","is-referenced-by-count":3,"title":["Geometrical determinants of cerebral artery fenestration for cerebral infarction"],"prefix":"10.7717","volume":"13","author":[{"given":"Yuqian","family":"Mei","sequence":"first","affiliation":[{"name":"School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, West China Hospital, Sichuan University, ChengDu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wu","sequence":"additional","affiliation":[{"name":"North Sichuan Medical College, Academic Affairs Office, Nanchong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingcheng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Magnetic Resonance Imaging, Hongqi Hospital, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Magnetic Resonance Imaging, Hongqi Hospital, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"issue":"2","key":"10.7717\/peerj.18774\/ref-1","first-page":"111","article-title":"Magnetic resonance imaging criteria for thrombolysis in hyperacute cerebral infarction","volume":"40","author":"Ahmetgjekaj","year":"2014","journal-title":"Current Health Sciences Journal"},{"issue":"11","key":"10.7717\/peerj.18774\/ref-2","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1080\/00207454.2020.1773820","article-title":"Evaluation of hemodynamic characteristics in posterior circulation infarction patients with vertebral artery dominance by color doppler flow imaging and transcranial doppler sonography","volume":"131","author":"Chen","year":"2021","journal-title":"International Journal of Neuroscience"},{"issue":"4","key":"10.7717\/peerj.18774\/ref-3","first-page":"585","article-title":"Angiographic and embryologic considerations in five cases of middle cerebral artery fenestration","volume":"23","author":"Gailloud","year":"2002","journal-title":"AJNR. 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