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RT Journal Article
SR Electronic
T1 Added Value of High-Resolution MR Imaging in the Diagnosis of Vertebral Artery Dissection
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1707
OP 1712
DO 10.3174/ajnr.A2165
VO 31
IS 9
A1 Naggara, O.
A1 Louillet, F.
A1 Touzé, E.
A1 Roy, D.
A1 Leclerc, X.
A1 Mas, J.-L.
A1 Pruvo, J.-P.
A1 Meder, J.-F.
A1 Oppenheim, C.
YR 2010
UL http://www.ajnr.org/content/31/9/1707.abstract
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