In patients with symptomatic middle cerebral artery atherosclerotic stenosis, MESs were observed more frequently in the PR group than in the non-PR group.

Background: To summarize the characteristics of primary central nervous system vasculitis from clinical, imaging, and pathological aspects by retrospective study. Methods: From March 2015 to December 2017, the data of the inpatients of primary central nervous system vasculitis in first Hospital of Jilin University were collected, and their clinical manifestation, imaging, and pathological characteristics were analyzed by using a descriptive method. Results: There were 18 patients, 10 males (55.56%) and 8 females (44.44%) separately. The age ranges from 16 years old to 49 years old, with the median age of 32 years old. There were 8 cases (44.44%) of epileptic seizure, 6 cases (33.33%) of abnormal behavior and cognition, 10 cases (55.56%) with sensorimotor abnormalities, 4 cases (22.22%) with dizziness, 4 cases (22.22%) with headache, 2 cases (11.11%) with facial pain, 2 cases (11.11%) with blurred vision, and 2 cases (11.11%) with unstable walking. Eight patients (44.44%) were identified with cerebral spinal fluid abnormalities. There were 12 cases (66.67%) with bilateral lesions and 6 cases (33.33%) with unilateral lesions, including the frontal lobe (18 cases, 100%), the parietal lobe (10 cases, 55.56%), the temporal and occipital lobe (8 cases, 44.44%). There were 12 cases (66.67%) combined with subcortical white matter involvement, 6 cases (33.33%) combined with meningeal involvement, 2 cases (11.11%) complicated with basal ganglia involvement and 2 cases (11.11%) complicated with spinal cord involvement. Most of the lesions were with unclear border (16 cases, 88.89%), 2 cases (11.11%) were with clear border. Cortical atrophy was identified in 6 cases (33.33%). There were 12 cases (66.67%) with the enhancement of the lesions and meningeal. The 3D Vessel Wall magnetic resonance imaging (VW-MRI) showed uniform thickness in all patients (18/18) with contrast enhancement of the vessel wall of the vasculitis artery. Conclusions: The clinical manifestation and imaging in primary central nervous system vasculitis are diverse. The 3D VW-MRI could achieve quantification assessment of vasculitis and provide more utility for primary angiitis of the central nervous system.

ObjectiveWe aimed to investigate the value of three-dimensional (3D) T1 volumetric isotropic turbo spin echo acquisition (VISTA) in the diagnosis of cervical artery dissection (CAD).MethodsWe prospectively included patients who were suspected as having a CAD within 1 month of onset. For T1 VISTA, the diagnosis of the dissection was based on the presence of intramural high-signal, intimal flap, double lumen and aneurysmal dilation. The final diagnosis of dissection was based on the clinical history, physical examination, and all of the imaging tests.ResultsA total of 46 patients were included in this study. The final diagnosis of CAD was made for 21 patients. Diagnosis of dissection was made for 20 of the 21 patients after assessing T1 VISTA. A definitive diagnosis of dissection was not made for 5 patients (including 3 patients with digital subtraction angiography) before the T1 VISTA examination. The sensitivity and specificity for T1 VISTA were 95.2% (95% CI, 76.2% to 99.9%) and 100% (95% CI, 86.3% to 100%), respectively. The agreement between the two researchers for T1 VISTA for diagnosis of CAD was very good (k=0.91). For patients without acute artery occlusion, all of them had a definite conclusion with or without dissection by T1 VISTA (n=29). However, for 17 patients with acute artery occlusion, the possibility of dissection could not be excluded for 6 of them by T1 VISTA (p=0.001).Conclusions3D T1 VISTA at 3.0 Tesla was useful in the diagnosis of acute CAD. However, for some patients with total occlusion of the artery without typical imaging features of dissection, the unequivocal distinction between intramural haematoma and intraluminal thrombus may be not adequate by T1 VISTA alone. Future studies should investigate whether a follow-up scan, a contrast-enhanced imaging or an optimal VISTA technique could be useful.

Hemorrhagic transformation is the major complication of intravenous thrombolysis. Calcification is used widely as an imaging indicator of atherosclerotic burden and cerebrovascular function. The relationship between intracranial calcification and hemorrhagic transformation has not been explored fully. We aimed to identify and quantify calcification in the main cerebral vessels to investigate the correlations between quantitative calcification parameters, hemorrhagic transformation, and prognosis. Methods: Acute, non-cardiogenic, ischemic stroke patients with anterior circulation who received intravenous thrombolysis therapy in the First Hospital of Jilin University were retrospectively and consecutively included. All included patients underwent a baseline CT before intravenous thrombolysis and a follow-up CT at 24 hours. A third-party software, ITK-SNAP, was used to segment and measure the calcification volume. A vascular nonbone component with a CT value 130 HU was considered calcified. Hemorrhagic transformation was determined based on the ECASS II classification criteria. Results:The study included 242 patients, 214 of whom were identified as having calcification. Thirty-one patients developed hemorrhagic transformation. The calcification volume on the lesion side (0.1ml) was associated with hemorrhagic transformation (p 0.004, OR 1.504, 95% CI: 1.140-1.985). Ninety-six patients had poor prognoses. The poor prognosis group had more calcified vessels than the good prognosis group (p 0.014, OR 1.477, 95% CI: 1.083-2.015). Conclusions:The arterial calcification volume on the lesion side is associated with hemorrhagic transformation after thrombolysis. The higher the number of calcified vessels, the greater the risk of poor prognosis.for early reperfusion, significantly reducing disability and fatality in acute ischemic stroke patients 1,2) . However, it is still accompanied by a 2-7% risk of symp-

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