OBJECTIVES: To evaluate the feasibility of high-resolution MRI (HR-MRI) for diagnosing intracranial vertebrobasilar artery dissection (VBD) and to identify the most useful imaging findings suggesting dissection. METHODS: We retrospectively reviewed 50 patients with suspected intracranial VBDs who underwent HR-MRI. Two neuroradiologists independently reviewed the HR-MR images. The diagnosis based on HR-MRI was compared with the final diagnosis by consensus among the neuroradiologists, neurointerventionist, and neurologist. Two neuroradiologists also sought signs of dissection (mural hematoma, dissection flap, outer-diameter enlargement on T2WI of steno-occlusive lesions). Inter- and intraobserver agreements were analysed. RESULTS: HR-MRI corroborated the final diagnosis in 47 (94%; 31 VBD and 16 non-VBD) patients. A mural haematoma was best detected on T1WI and contrast-enhanced (CE)-T1WI (54.3%). Dissection flaps were observed in almost all cases on CE-T1WI (91.4 %), and then were detected on T2WI (68.6%). Outer-diameter enlargement of the steno-occlusive lesions on angiography was detected in more than half of the cases (62.9%). The two reviewers showed almost perfect agreement for the diagnosis of VBD and detecting dissection signs on every sequence. CONCLUSIONS: HR-MRI can be a useful and non-invasive diagnostic tool for intracranial VBD, and dissection flaps on CE-T1WI are the signs with the greatest diagnostic value. KEY POINTS: Direct imaging findings of dissection were well visualised by HR-MRI. Detection of a dissection flap on CE-T1WI is the most reliable diagnostic finding. HR-MRI could be a useful diagnostic tool for intracranial VBDs.
OBJECTIVES: To evaluate the feasibility of high-resolution MRI (HR-MRI) for diagnosing intracranial vertebrobasilar artery dissection (VBD) and to identify the most useful imaging findings suggesting dissection. METHODS: We retrospectively reviewed 50 patients with suspected intracranial VBDs who underwent HR-MRI. Two neuroradiologists independently reviewed the HR-MR images. The diagnosis based on HR-MRI was compared with the final diagnosis by consensus among the neuroradiologists, neurointerventionist, and neurologist. Two neuroradiologists also sought signs of dissection (mural hematoma, dissection flap, outer-diameter enlargement on T2WI of steno-occlusive lesions). Inter- and intraobserver agreements were analysed. RESULTS: HR-MRI corroborated the final diagnosis in 47 (94%; 31 VBD and 16 non-VBD) patients. A mural haematoma was best detected on T1WI and contrast-enhanced (CE)-T1WI (54.3%). Dissection flaps were observed in almost all cases on CE-T1WI (91.4 %), and then were detected on T2WI (68.6%). Outer-diameter enlargement of the steno-occlusive lesions on angiography was detected in more than half of the cases (62.9%). The two reviewers showed almost perfect agreement for the diagnosis of VBD and detecting dissection signs on every sequence. CONCLUSIONS: HR-MRI can be a useful and non-invasive diagnostic tool for intracranial VBD, and dissection flaps on CE-T1WI are the signs with the greatest diagnostic value. KEY POINTS: Direct imaging findings of dissection were well visualised by HR-MRI. Detection of a dissection flap on CE-T1WI is the most reliable diagnostic finding. HR-MRI could be a useful diagnostic tool for intracranial VBDs.
Authors: O Naggara; F Louillet; E Touzé; D Roy; X Leclerc; J-L Mas; J-P Pruvo; J-F Meder; C Oppenheim Journal: AJNR Am J Neuroradiol Date: 2010-07-01 Impact factor: 3.825
Authors: Seung Chai Jung; Ho Sung Kim; Choong-Gon Choi; Sang Joon Kim; Sun U Kwon; Dong-Wha Kang; Jong S Kim Journal: Clin Neuroradiol Date: 2016-09-27 Impact factor: 3.649