INTRODUCTION: Cervical artery dissection is an important cause of ischemic stroke, particularly in young patients. The diagnosis can be made with invasive catheter angiography or non-invasive imaging, either with MRI in conjunction with MR angiography (MRA) or CT angiography (CTA). Both modalities have been shown to have a high specificity and sensitivity. New developments such as multi-slice CTA (MSCTA) are emerging as an alternative methods for imaging the cervical and intracranial arteries. However, the contribution of modern MSCTA to carotid artery dissection has not been reported. METHODS: We present a retrospective series of seven patients in whom both MSCTA and cervical axial T1 MRI and MRA were performed in the acute to subacute setting of internal carotid artery dissection. RESULTS: Carotid artery dissection was identified in all seven patients by MSCTA. The combination of MRI and MRA identified dissection in five of the seven patients. Additionally, a pseudoaneurysm was identified by MSCTA that was missed by MRI and MRA. CONCLUSION: Our findings confirm that MSCTA is a complementary technique in comparison to cervical axial T1 MRI and cervical MRA for diagnosing carotid artery dissection, and at times may provide additional information that can impact patient management.
INTRODUCTION: Cervical artery dissection is an important cause of ischemic stroke, particularly in young patients. The diagnosis can be made with invasive catheter angiography or non-invasive imaging, either with MRI in conjunction with MR angiography (MRA) or CT angiography (CTA). Both modalities have been shown to have a high specificity and sensitivity. New developments such as multi-slice CTA (MSCTA) are emerging as an alternative methods for imaging the cervical and intracranial arteries. However, the contribution of modern MSCTA to carotid artery dissection has not been reported. METHODS: We present a retrospective series of seven patients in whom both MSCTA and cervical axial T1 MRI and MRA were performed in the acute to subacute setting of internal carotid artery dissection. RESULTS: Carotid artery dissection was identified in all seven patients by MSCTA. The combination of MRI and MRA identified dissection in five of the seven patients. Additionally, a pseudoaneurysm was identified by MSCTA that was missed by MRI and MRA. CONCLUSION: Our findings confirm that MSCTA is a complementary technique in comparison to cervical axial T1 MRI and cervical MRA for diagnosing carotid artery dissection, and at times may provide additional information that can impact patient management.
Authors: Nicholas V Stence; Laura Z Fenton; Neil A Goldenberg; Jennifer Armstrong-Wells; Timothy J Bernard Journal: Curr Treat Options Neurol Date: 2011-12 Impact factor: 3.598
Authors: Peter B Sporns; Thomas Niederstadt; Walter Heindel; Michael J Raschke; René Hartensuer; Ralf Dittrich; Uta Hanning Journal: Clin Neuroradiol Date: 2018-01-26 Impact factor: 3.649
Authors: A T Vertinsky; N E Schwartz; N J Fischbein; J Rosenberg; G W Albers; G Zaharchuk Journal: AJNR Am J Neuroradiol Date: 2008-07-17 Impact factor: 3.825