Diagnostic Value of Contrast-Enhanced Magnetic Resonance Vessel Wall Imaging on the Onset Type of Vertebral Artery Dissection

2019 ◽  
Vol 48 (3-6) ◽  
pp. 124-131 ◽  
Author(s):  
Atsushi Saito ◽  
Miki Fujimura ◽  
Hidenori Endo ◽  
Shunsuke Omodaka ◽  
Atsushi Kanoke ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Vessel Wall ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Onset Type ◽  
Clinical Onset ◽  
Aneurysm Wall ◽  
Incidental Group ◽  
Wall Imaging

Background: Circumferential enhancement along the aneurysm wall (CEAW) by magnetic resonance (MR) vessel wall imaging has been reported to be a useful indicator for the biological activity of intracranial aneurysms such as growth and rupture. However, the significance of CEAW in vertebral artery dissection (VAD) has not been examined in detail. We quantitatively analyzed CEAW on VAD focusing on the differences in the clinical onset type. Methods: The subjects were 37 patients diagnosed with VAD who were evaluated by MR imaging in the acute phase of onset between January 2014 and May 2019. The clinical onset of VAD was categorized into 3 subtypes: (1) incidentally detected (incidental group), (2) sudden headache without cerebral ischemia and/or intracranial hemorrhage (headache group), and (3) hemorrhagic onset (hemorrhage group). Three-dimensional T1-weighted fast spin echo sequences were obtained before and after contrast material injection, and the contrast ratio (CR) of the aneurysm wall against the pituitary stalk was calculated as the indicator of CEAW. Results: The CR values of VAD in the hemorrhage group were significantly higher than those in the headache group (0.95 vs. 0.65, p < 0.05), and the headache group had significantly higher CR values than the incidental group (0.65 vs. 0.56, p < 0.05). On receiver operating characteristic curve analysis, the optimal cutoff value of CR to distinguish the hemorrhage group from the headache group was 0.83 and that to distinguish the headache group from the incidental group was 0.61. Conclusion: The extent of CEAW precisely reflected the deleterious impact of VAD in the acute stage, including hemorrhagic presentation. The predictive value of CEAW for the prognosis of unruptured VAD should be evaluated in future studies.

Monitoring Intramural Hematoma on Vessel Wall Imaging to Evaluate the Healing of Intracranial Vertebral Artery Dissection

2021 ◽  
Vol 30 (9) ◽  
pp. 105992
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Michitsura Yoshiyama ◽  
Hiroki Takahashi ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vessel Wall ◽  
Vertebral Artery Dissection ◽  
Intramural Hematoma ◽  
Vessel Wall Imaging ◽  
Artery Dissection ◽  
Wall Imaging

scholarly journals Vertebral Artery Dissection Mimicking Migraine: A Case Report

2021 ◽  
Vol 7 (1) ◽  
pp. 21-24
Author(s):  
Rahalkar Kshitij ◽  
◽  
Hong K. Lau ◽  
R Ponampalam ◽  
◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Thrombus Formation ◽  
Vertebral Artery Dissection ◽  
Vascular Occlusion ◽  
Antiplatelet Agents ◽  
Vascular Wall ◽  
Neurological Deficits ◽  
Artery Dissection ◽  
Common Symptom

Vertebral artery dissection (VAD) is caused by an intimal tear that leads to bleeding into the vascular wall, which may cause vascular occlusion by thrombus formation and subsequent distal emboli (leading to ischemic stroke), aneurysm formation and subarachnoid hemorrhage. Cervical artery dissections (either carotid or vertebral artery dissection) are an important cause of stroke in patients under 50-years of age. Headache with or without neck pain is a common symptom. Usually, it occurs with focal neurological signs but sometimes it may occur without any neurological deficits and may mimic migraine. Often it occurs spontaneously without trauma but sometimes there is history of minor traumas, sudden neck movements or chiropractic manipulation. Imaging modalities include magnetic resonance imaging (MRI) brain, magnetic resonance angiography (MRA), and computed tomography angiography (CTA). Treatment involves anticoagulation or antiplatelet agents.

Intracranial vessel wall MR imaging of an intradural vertebral artery dissection

2020 ◽  
Vol 68 ◽  
pp. 108-110 ◽  
Author(s):  
Kofi-Buaku Atsina ◽  
Aaron Rothstein ◽  
Steven R. Messé ◽  
Jae W. Song
Keyword(s):  
Mr Imaging ◽  
Vertebral Artery ◽  
Vessel Wall ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Intracranial Vessel

Magnetic resonance vessel wall imaging predicts morphological deterioration in unruptured intracranial artery dissection

2020 ◽  
Vol 29 (9) ◽  
pp. 105006
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Hiroki Takahashi ◽  
Tatsuya Mizoue ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Intracranial Artery Dissection ◽  
Wall Imaging

scholarly journals Concentration of Lp(a) (Lipoprotein[a]) in Aneurysm Sac Is Associated With Wall Enhancement of Unruptured Intracranial Aneurysm

Stroke ◽  
2021 ◽  
Author(s):  
Daizo Ishii ◽  
Mario Zanaty ◽  
Jorge A. Roa ◽  
Luyuan Li ◽  
Yongjun Lu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vessel Wall ◽  
Degenerative Change ◽  
Vessel Wall Imaging ◽  
Parent Artery ◽  
Lipoprotein A ◽  
Aneurysm Wall ◽  
Unruptured Intracranial Aneurysms ◽  
A Prospective Study ◽  
Wall Imaging

Background and Purpose: Atherosclerotic remodeling of the aneurysm wall, which could be detected as aneurysm wall enhancement (AWE) by magnetic resonance–vessel wall imaging, is a part of degenerative change of unruptured intracranial aneurysms (UIAs). The purpose of this study was to determine whether the luminal concentrations of atherosclerotic proteins in the aneurysm sac were associated with increased wall enhancement of UIAs in vessel wall imaging. Methods: We performed a prospective study of subjects undergoing endovascular treatments for UIAs. All subjects underwent evaluation using 3T–magnetic resonance imaging, including pre/postcontrast vessel wall imaging of the UIAs. Blood samples were collected from the aneurysm sac and the parent artery during endovascular procedures. Presence/absence of AWE was correlated with the delta difference in concentration for each atherosclerotic protein between the lumen of UIA and in the parent artery. Results: A total of consecutive 17 patients with 19 UIAs were enrolled. The delta difference of lipoprotein(a) was significantly higher in UIAs with AWE compared with those without AWE (−6.9±16.0 versus −45.4±44.9 μg/mL, P =0.03). Conclusions: Higher luminal concentrations of lipoprotein(a) in the aneurysm sac were significantly associated with increased wall enhancement of UIAs. A larger study is needed to confirm these findings.

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