BACKGROUND AND PURPOSE: Vessel wall inflammation (VWI) may be a pathogenetic factor in cervical artery dissection (CAD). We used contrast-enhanced high-resolution MRI (hrMRI) and positron emission tomography CT (PET-CT) to systematically investigate VWI in spontaneous CAD. METHODS: In this monocentric, prospective, observational study, all consecutive patients with acute, MRI-confirmed, spontaneous CAD admitted to our center between August 2007 and August 2009 were included. VWI was defined as perivascular contrast enhancement in hrMRI and increased perivascular [18F]-fluorodesoxyglucose uptake in PET-CT. VWI was further differentiated between local (restricted to the site of dissection) and generalized (exceeding the site of dissection). RESULTS: A total of 37 patients were included. Multiple dissections were seen in 10 patients (27%). Twenty-five patients received both modalities as planned, 8 received only PET-CT, and 4 received only hrMRI. A subset of patients showed signs of a generalized VWI in hrMRI (4/29 patients, 14%) and PET-CT (8/33 patients, 24%). In patients who received both modalities, all with hrMRI signs of generalized VWI were PET-CT positive (3/3), whereas some PET-CT-positive patients were hrMRI-negative (4/7). If present, generalized VWI in hrMRI completely resolved within 6 months. The presence of >2 simultaneous dissections (seen in 2 patients) was significantly associated with generalized VWI in hrMRI (P=0.015) but marginally not in PET-CT (P=0.053). CONCLUSIONS: A subset of patients with spontaneous CAD showed signs of a generalized transient inflammatory arteriopathy in contrast-enhanced hrMRI and PET-CT. This subset of patients may be more prone to multiple dissections.
BACKGROUND AND PURPOSE: Vessel wall inflammation (VWI) may be a pathogenetic factor in cervical artery dissection (CAD). We used contrast-enhanced high-resolution MRI (hrMRI) and positron emission tomography CT (PET-CT) to systematically investigate VWI in spontaneous CAD. METHODS: In this monocentric, prospective, observational study, all consecutive patients with acute, MRI-confirmed, spontaneous CAD admitted to our center between August 2007 and August 2009 were included. VWI was defined as perivascular contrast enhancement in hrMRI and increased perivascular [18F]-fluorodesoxyglucose uptake in PET-CT. VWI was further differentiated between local (restricted to the site of dissection) and generalized (exceeding the site of dissection). RESULTS: A total of 37 patients were included. Multiple dissections were seen in 10 patients (27%). Twenty-five patients received both modalities as planned, 8 received only PET-CT, and 4 received only hrMRI. A subset of patients showed signs of a generalized VWI in hrMRI (4/29 patients, 14%) and PET-CT (8/33 patients, 24%). In patients who received both modalities, all with hrMRI signs of generalized VWI were PET-CT positive (3/3), whereas some PET-CT-positive patients were hrMRI-negative (4/7). If present, generalized VWI in hrMRI completely resolved within 6 months. The presence of >2 simultaneous dissections (seen in 2 patients) was significantly associated with generalized VWI in hrMRI (P=0.015) but marginally not in PET-CT (P=0.053). CONCLUSIONS: A subset of patients with spontaneous CAD showed signs of a generalized transient inflammatory arteriopathy in contrast-enhanced hrMRI and PET-CT. This subset of patients may be more prone to multiple dissections.
Authors: Caspar Grond-Ginsbach; Bowang Chen; Rastislav Pjontek; Tina Wiest; Yanxiang Jiang; Barbara Burwinkel; Sandrine Tchatchou; Michael Krawczak; Stefan Schreiber; Tobias Brandt; Manja Kloss; Marie-Luise Arnold; Kari Hemminki; Christoph Lichy; Philippe A Lyrer; Ingrid Hausser; Stefan T Engelter Journal: Eur J Hum Genet Date: 2012-05-23 Impact factor: 4.246
Authors: Tiina M Metso; Stéphanie Debette; Caspar Grond-Ginsbach; Stefan T Engelter; Didier Leys; Tobias Brandt; Alessandro Pezzini; Anna Bersano; Manja Kloss; Vincent Thijs; Philippe A Lyrer; Turgut Tatlisumak; Antti J Metso Journal: J Neurol Date: 2012-04-18 Impact factor: 4.849
Authors: E M Coppenrath; N Lummel; J Linn; O Lenz; M Habs; K Nikolaou; M F Reiser; M Dichgans; T Pfefferkorn; T Saam Journal: Eur Radiol Date: 2013-06-04 Impact factor: 5.315