G Adam1, J Darcourt1, M Roques1, M Ferrier1, R Gramada1, Z Meluchova1, S Patsoura1, A Viguier2, C Cognard1, V Larrue2, F Bonneville3. 1. From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.). 2. Neurology (A.V., V.L.), Centre Hospitalier Universitaire Toulouse, Pierre-Paul Riquet Hospital, Toulouse, France. 3. From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.) bonneville.f@chu-toulouse.fr.
Abstract
BACKGROUND AND PURPOSE: The ICA is the most common site of cervical artery dissection. Prompt and reliable identification of the mural hematoma is warranted when a dissection is clinically suspected. The purpose of this study was to assess to capacity of a standard DWI sequence acquired routinely on the brain to detect dissecting hematoma related to cervical ICA dissections. MATERIALS AND METHODS: This was a retrospective study of a cohort of 110 patients younger than 55 years of age (40 women; mean age, 46.79 years) admitted at the acute phase of a neurologic deficit, headache, or neck pain and investigated by at least a standard 3T diffusion-weighted sequence of the brain. Among them were 50 patients (14 women; mean age, 46.72 years) with subsequently confirmed ICA dissection. In the whole anonymized cohort, both a senior and junior radiologist separately assessed, on the DWI sequences only, the presence of a crescent-shaped or circular hypersignal projecting on the subpetrosal segment of the ICA arteries, assuming that it would correspond to a mural hematoma related to an ICA dissection. RESULTS: The senior radiologist found 46 subpetrosal hyperintensities in 43/50 patients with ICA dissection and none in patients without dissection (sensitivity, 86%; specificity, 100%). The junior radiologist found 48 subpetrosal hyperintensities in 45/50 patients with dissection and none in patients without dissection (sensitivity, 90%; specificity, 100%). CONCLUSIONS: In our cohort, a standard DWI sequence performed on the brain at the acute phase of a stroke or for a clinical suspicion of dissection detected nearly 90% of cervical ICA dissections.
BACKGROUND AND PURPOSE: The ICA is the most common site of cervical artery dissection. Prompt and reliable identification of the mural hematoma is warranted when a dissection is clinically suspected. The purpose of this study was to assess to capacity of a standard DWI sequence acquired routinely on the brain to detect dissecting hematoma related to cervical ICA dissections. MATERIALS AND METHODS: This was a retrospective study of a cohort of 110 patients younger than 55 years of age (40 women; mean age, 46.79 years) admitted at the acute phase of a neurologic deficit, headache, or neck pain and investigated by at least a standard 3T diffusion-weighted sequence of the brain. Among them were 50 patients (14 women; mean age, 46.72 years) with subsequently confirmed ICA dissection. In the whole anonymized cohort, both a senior and junior radiologist separately assessed, on the DWI sequences only, the presence of a crescent-shaped or circular hypersignal projecting on the subpetrosal segment of the ICA arteries, assuming that it would correspond to a mural hematoma related to an ICA dissection. RESULTS: The senior radiologist found 46 subpetrosal hyperintensities in 43/50 patients with ICA dissection and none in patients without dissection (sensitivity, 86%; specificity, 100%). The junior radiologist found 48 subpetrosal hyperintensities in 45/50 patients with dissection and none in patients without dissection (sensitivity, 90%; specificity, 100%). CONCLUSIONS: In our cohort, a standard DWI sequence performed on the brain at the acute phase of a stroke or for a clinical suspicion of dissection detected nearly 90% of cervical ICA dissections.
Authors: G Marnat; M Bühlmann; O F Eker; J Gralla; P Machi; U Fischer; C Riquelme; M Arnold; A Bonafé; S Jung; V Costalat; P Mordasini Journal: AJNR Am J Neuroradiol Date: 2018-04-26 Impact factor: 3.825
Authors: W Ben Hassen; A Machet; M Edjlali-Goujon; L Legrand; A Ladoux; C Mellerio; E Bodiguel; M-P Gobin-Metteil; D Trystram; C Rodriguez-Regent; J-L Mas; M Plat; C Oppenheim; J-F Meder; O Naggara Journal: Diagn Interv Imaging Date: 2014-12 Impact factor: 4.026