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PT  - JOURNAL ARTICLE
AU  - Naggara, O.
AU  - Louillet, F.
AU  - Touzé, E.
AU  - Roy, D.
AU  - Leclerc, X.
AU  - Mas, J.-L.
AU  - Pruvo, J.-P.
AU  - Meder, J.-F.
AU  - Oppenheim, C.
TI  - Added Value of High-Resolution MR Imaging in the Diagnosis of Vertebral Artery Dissection
AID  - 10.3174/ajnr.A2165
DP  - 2010 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1707--1712
VI  - 31
IP  - 9
4099  - http://www.ajnr.org/content/31/9/1707.short
4100  - http://www.ajnr.org/content/31/9/1707.full
SO  - Am. J. Neuroradiol.2010 Oct 01; 31
AB  - BACKROUND AND PURPOSE: The optimal imaging method for the diagnosis of VAD remains undefined. Our aim was to evaluate the added value of HR-MR imaging for the diagnosis of VAD. MATERIALS AND METHODS: We retrospectively extracted 35 consecutive patients suspected of having acute VAD who had the following: 1) a focal lumen abnormality of the VA on CE-MRA, 2) HR-MR imaging during the initial hospital stay, and 3) clinical and imaging follow-up within 6 months. Two neurologists classified patients as either VAD (group A) or non-VAD (group B) by reviewing all the available data at hospital discharge, except HR-MR imaging data. On HR-MR imaging, 2 radiologists searched for signs of acute VAD. The 2 classifications were compared. In case of discordance, CE-MRA follow-up and axial fat-suppressed T1WI, used to obtain supportive evidence for or against VAD, were considered as the standard of reference. RESULTS: In 4/18 patients in group A, HR-MR imaging did not demonstrate any signs of acute VAD and perivertebral signal-intensity changes were attributed to venous plexus, with an unchanged lumen on follow-up. In 4/17 patients in group B, HR-MRI demonstrated a mural hematoma, with lumen normalization on follow-up CE-MRA. CONCLUSIONS: Our results encourage the use of HR-MR imaging as a second-line diagnostic tool in the event of suspicion of acute VAD and doubtful findings on standard imaging. CE-MRAcontrast-enhanced MR angiographyCIconfidence intervalDSAdigital subtraction angiographyDUSDoppler ultrasonography examinationDWIdiffusion-weighted imagingHRhigh resolutionNIHSSNational Institutes of Health Stroke ScalePDWIproton attenuation− weighted imagingT1WIT1-weighted imagingT2WIT2-weighted imagingTEeffeffective echo-timeTOFtime of flightV2 and V3the second and third VA segmentsVAvertebral arteryVADVA dissection