Magnetic resonance imaging study of intracranial vertebrobasilar artery dissections.

Kitanaka, Chifumi; Tanaka, J; Kuwahara, Masanori; Teraoka, Akira

doi:10.1161/01.str.25.3.571

Cited by 114 publications

(57 citation statements)

References 12 publications

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“…Although previous reports have described that arterial dissection in the posterior circulation frequently involved 2 or 3 vessels on the basis of pathological studies 5,6 or angiographic 7 or MR findings, 12 its incidence is obscure. In the majority of reported cases, arterial dissections were limited to 1 vessel.…”

Section: Vascular Imagingmentioning

confidence: 97%

“…According to Kitanaka et al, 12 intramural hematoma of intracranial dissected vertebral artery was best revealed in the subacute to early chronic stage, but after 2 months, intramural hematoma could not be seen on MR images. On the basis of a review of patients with thoracic aortic dissections, Murray et al 24 found a moderately strong correlation between the number of days after symptom onset and the signal intensity of the intramural hematoma, and they showed that T1-weighted images obtained within a week after onset rarely revealed high signal intensity.…”

Section: Mr Imagingmentioning

confidence: 99%

“…In the majority of reported cases, arterial dissections were limited to 1 vessel. 2,3,12,19 Because of the limitation of each neuroradiological examination or field of view of the operation, the extension of arterial dissection might be an underestimation. In our present study we evaluated the extension of the arterial dissection on the basis of both MR and angiographic findings.…”

Section: Vascular Imagingmentioning

confidence: 99%

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Clinical and Neuroradiological Features of Intracranial Vertebrobasilar Artery Dissection

Hosoya

Adachi

Yamaguchi

et al. 1999

Stroke

208

172

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Background and Purpose-We sought to determine the clinical and neuroradiological features of intracranial vertebrobasilar artery dissection. Methods-The clinical features and MR findings of 31 patients (20 men and 11 women) with intracranial vertebrobasilar artery dissections confirmed by vertebral angiography were analyzed retrospectively. The vertebral angiography revealed the double lumen sign in 11 patients (13 arteries) and the pearl and string sign in 20 patients (28 arteries). Results-The patients ranged in age from 25 to 82 years (mean, 54.8 years). Clinical symptoms due to ischemic cerebellar and/or brain stem lesions were common, but in 3 cases the dissections were discovered incidentally while an unrelated disorder was investigated. Headache, which has been emphasized as the only specific clinical sign of vertebrobasilar artery dissection, was found in 55% of the patients. Intramural hematoma on T1-weighted images has been emphasized as a specific MR finding. The positive rate of intramural hematoma was 32%. Double lumen on 3-dimensional (3-D) spoiled gradient-recalled acquisition (SPGR) images after the injection of contrast medium was identified in 87% of the patients. The 3-D SPGR imaging method is considered useful for the screening of vertebrobasilar artery dissection. Conclusions-Intracranial vertebrobasilar artery dissection is probably much more frequent than previously considered.Such patients may present no or only minor symptoms. Neuroradiological screening for posterior circulation requires MR examinations, including contrast-enhanced 3-D SPGR. Angiography may be necessary for the definite diagnosis of intracranial vertebrobasilar artery dissection because the sensitivity of the finding of intramural hematoma is not satisfactory.

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Section: Vascular Imagingmentioning

confidence: 97%

Section: Mr Imagingmentioning

confidence: 99%

Section: Vascular Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and Neuroradiological Features of Intracranial Vertebrobasilar Artery Dissection

Hosoya

Adachi

Yamaguchi

et al. 1999

Stroke

208

172

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“…44,45 Among 7 patients with intracranial vertebral-basilar dissection, no patient had vessel wall hyperintensity on T1-weighted VW-MR imaging within a week of symptom onset, but 5 patients had hyperintensity in a subsequent week.…”

mentioning

confidence: 99%

Intracranial Vessel Wall MRI: Principles and Expert Consensus Recommendations of the American Society of Neuroradiology

Mandell

Mossa‐Basha

Qiao

et al. 2016

AJNR Am J Neuroradiol

520

456

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SUMMARY:Intracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging with CTA, MRA, or DSA. The technique has multiple potential uses in the context of ischemic stroke and intracranial hemorrhage. There remain gaps in our understanding of intracranial vessel wall MR imaging findings and research is ongoing, but the technique is already used on a clinical basis at many centers. This article, on behalf of the Vessel Wall Imaging Study Group of the American Society of Neuroradiology, provides expert consensus recommendations for current clinical practice. ABBREVIATIONS: RCVS ϭ reversible cerebral vasoconstriction syndrome; VW-MR imaging ϭ vessel wall MR imaging

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“…With time-of-flight MRA in diagnosing VAD, some issues include confusing high signal intensity caused by the venous plexus or fat surrounding the VAs, the isointensity of an intramural hematoma in the acute phase, and the low resolution of visualizing relatively small VAs. 11,13 Review of imaging should also consider the normal soft tissue and venous anatomy in the suboccipital region below the foramen magnum. The anatomy of the normal suboccipital cavernous sinus and its communications (VA venous plexus, anterior condylar vein, posterior condylar vein, internal vertebral venous plexus, and marginal sinus) requires adequate understanding to correctly interpret vascular abnormalities of the V3 portion of the VA.…”

Section: Figmentioning

confidence: 99%

Vertebral Artery Dissection with a Normal-Appearing Lumen at Multisection CT Angiography: The Importance of Identifying Wall Hematoma

Lum¹,

Chakraborty²,

Schlossmacher³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:CT angiography (CTA) is widely used and may be the only vascular imaging technique ordered for emergent evaluation of neurovascular disease. With thin-section multisection CTA, the resolution of vessel wall imaging has improved. We describe cases of acute vertebral artery dissection (VAD) in which the only abnormality on CTA was a characteristic thickening of the wall of the V3 portion of the vertebral artery (VA). The arterial lumen at the dissection site was normal in caliber. This type of dissection is easily overlooked if only lumen-opacifying studies such as contrast MR angiography (MRA) or conventional angiography are performed. We highlight the importance of recognizing this finding, the "suboccipital rind" sign, in the V3 portion, a segment commonly affected in VAD. The purpose of our study was to review the CTA imaging characteristics of patients with VAD in the V3 portion compared with normal controls.

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Magnetic resonance imaging study of intracranial vertebrobasilar artery dissections.

Cited by 114 publications

References 12 publications

Clinical and Neuroradiological Features of Intracranial Vertebrobasilar Artery Dissection

Clinical and Neuroradiological Features of Intracranial Vertebrobasilar Artery Dissection

Intracranial Vessel Wall MRI: Principles and Expert Consensus Recommendations of the American Society of Neuroradiology

Vertebral Artery Dissection with a Normal-Appearing Lumen at Multisection CT Angiography: The Importance of Identifying Wall Hematoma

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