Intramural Hematoma Shape and Acute Cerebral Infarction in Intracranial Artery Dissection: A High-Resolution Magnetic Resonance Imaging Study

2020 ◽  
Vol 49 (3) ◽  
pp. 269-276
Author(s):  
Sang-Hun Lee ◽  
Jin-Man Jung ◽  
Keon-yeup Kim ◽  
Bum Joon Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebral Infarction ◽  
Intramural Hematoma ◽  
Distal Region ◽  
Proximal Region ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Resonance Imaging ◽  
Double Lumen ◽  
Intracranial Artery Dissection

Background: Intracranial artery dissection (IAD) is gaining recognition as an important cause of stroke, but limited information is available about the morphology of the dissection. This study aimed to investigate the relationship between acute cerebral infarctions and the shape of hematoma in patients with IADs using high-resolution magnetic resonance imaging (HRMRI). Methods: We enrolled consecutive patients who presented with vascular headaches, transient ischemic attacks, or ischemic strokes with acute IAD confirmed by HRMRI using key pathognomonic radiological findings of IAD, including intimal flap, intramural hematoma (IMH), and double lumen. All patients were enrolled and HRMRI was performed, both within 7 days of symptom onset. All patients with acute ischemic infarction within 7 days were enrolled. Patients were divided into 2 groups: those with a proximal dominant intramural hematoma (PIMH) and those with a distal dominant intramural hematoma (DIMH). A PIMH was defined as when the volume of the hematoma in the proximal region was greater than that in the distal region, and a DIMH was defined as when the distal region was greater than that in the proximal region. Clinical and radiological characteristics between the 2 groups were compared using univariable and multivariable logistic regression. Results: The mean age of the 42 participants was 52.6 ± 12.7 years, and 24 (57.1%) were male. Twenty-seven (64.3%) had a PIMH and 15 (35.7%) had a DIMH. Thirty-six (85.7%) showed a double lumen and 27 (64.3%) showed a dissecting flap. Acute infarction was observed in 31 (73.8%) patients. Patients with PIMHs showed a higher prevalence of cerebral infarction than those with DIMHs (96.3 vs. 33.3%; p < 0.001). Univariable (odds ratio [OR] 52.00; 95% confidence interval [CI] 5.386–502.082; p = 0.001) and multivariable (OR 65.43; 95% CI 5.20–822.92; p = 0.001) analyses showed that only dissection type was independently associated with the risk of cerebral infarction. Conclusion: In patients with cerebral artery dissections, the shape of IMHs was independently associated with cerebral infarction. PIMHs may be more closely associated with cerebral infarctions than DIMHs.

Evaluating intracranial artery dissection by using three-dimensional simultaneous non-contrast angiography and intra-plaque hemorrhage high-resolution magnetic resonance imaging: a retrospective study

2021 ◽  
pp. 028418512199223
Author(s):  
Min Tang ◽  
Jinglong Gao ◽  
Jie Gao ◽  
Xuejiao Yan ◽  
Xin Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Three Dimensional ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Diagnostic Efficiency ◽  
Intracranial Artery ◽  
Resonance Imaging ◽  
Double Lumen ◽  
Contrast Angiography ◽  
Intracranial Artery Dissection

Background There was no previous report on the three-dimensional simultaneous non-contrast angiography and intra-plaque hemorrhage (3D-SNAP) magnetic resonance imaging (MRI) sequence to diagnose intracranial artery dissection (IAD). Purpose To improve the diagnostic accuracy and guide the clinical treatment for IAD by elucidating its pathological features using 3D-SNAP MRI. Material and Methods From January 2015 to September 2018, 113 patients with suspected IAD were analyzed. They were divided into IAD and non-IAD groups according to the spontaneous coronary artery dissection (SCAD) criteria. All patients underwent 3D-SNAP, 3D-TOF, T2W imaging, 3D-PD, 3D-T1W-VISTA, and 3D-T1WCE) using 3.0-T MRI; clinical data were collected. The IAD imaging findings (intramural hematoma, double lumen, intimal flap, aneurysmal dilatation, stenosis, or occlusion) in every sequence were analyzed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficiency of each sequence. Results There was a significant difference in the probability of intramural hematoma, relative signal intensity of intramural hematoma, double lumen, stenosis, or occlusion signs on 3D-TOF, T2W, 3D-PD, 3D-T1W-VISTA, 3D-SNAP, and 3D-T1WCE sequences ( P<0.05). The 3D-SNAP and 3D-T1WCE sequences were most sensitive for diagnosing intramural hematoma and displaying double-lumen signs, respectively. The diagnostic efficiency of the 3D-SNAP sequence combined with 3D-T1WCE was the highest (area under the curve [AUC] 0.966). The AUC value of the 3D-SNAP sequence (AUC 0.897) was slightly inferior to that of 3D-T1W enhancement (AUC 0.903). Conclusion 3D-SNAP MRI is a non-invasive and effective method and had the greatest potential among those methods tested for improving the diagnostic accuracy for IAD.

scholarly journals M2 segment dissection of middle cerebral artery diagnosed using high-resolution magnetic resonance imaging

2017 ◽  
Vol 45 (6) ◽  
pp. 1802-1804
Author(s):  
Xiaoyan Song ◽  
Haiyan Lv ◽  
Jianjun Tang ◽  
Qing Zhang ◽  
Qiaoshu Wang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Imaging Technique ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Resonance Imaging ◽  
Intracranial Artery Dissection

Middle cerebral artery (MCA) dissection is a rare cause of ischemic stroke, especially in the M2 or M3 segments. Diagnosis of intracranial artery dissection remains challenging. We herein report a case of M2 segment dissection of the MCA with typical features of an intimal flap and intramural hematoma diagnosed using high-resolution 3T magnetic resonance imaging. This imaging technique might be a more effective noninvasive method by which to diagnose M2 segment dissection of the MCA than either computed tomography angiography or digital subtraction angiography.

scholarly journals Spontaneous intracranial vertebral artery dissection with acute ischemic stroke: High-resolution magnetic resonance imaging findings

2018 ◽  
Vol 31 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Soo Young Yun ◽  
Young Jin Heo ◽  
Hae Woong Jeong ◽  
Jin Wook Baek ◽  
Hye Jung Choo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
High Resolution ◽  
Diffusion Mri ◽  
Vertebral Artery Dissection ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Remodeling Index

Background Acute ischemic stroke (AIS) more frequently develops in patients with intracranial vertebral artery dissection (VAD) than extracranial VAD, and is associated with possible poor clinical outcomes. The aim of this study is to compare high-resolution magnetic resonance imaging (HR-MRI) findings and clinical features of VAD with and without AIS. Methods Twenty-nine lesions from 27 patients (15 male and 12 female patients; age range = 28–73 years) who underwent diffusion MRI and 3T HR-MRI within seven days were included. We classified VAD according to the presence of AIS lesions on diffusion MRI. Clinical features and HR-MRI findings (angiographic patterns, presence of double lumen sign, dissecting flap, posterior inferior cerebellar artery involvement, remodeling index, length of affected vessels, T1-signal intensity, area of intramural hematoma, and grades and patterns of vessel wall enhancement) were evaluated. Results Thirteen VADs with AIS and 16 without AIS were included. There were no significant differences in the clinical parameters (sex, age, risk factors, symptoms). More VADs with AIS presented as a steno-occlusive pattern than VADs without AIS. More VADs without AIS presented with aneurysmal dilation, larger mean remodeling index and longer mean length than VADs with AIS. Presence of intramural hematoma, T1-iso-signal intensity of intramural hematoma and contrast enhancement were significantly more common in VADs with AIS than without AIS. Conclusions Our study showed some differences in HR-MRI comparing intracranial VAD patients with and without AIS. Differing findings may facilitate a better understanding of intracranial VAD and risk assessment of AIS in these patients.

A rare case of cerebral proliferative angiopathy with acute cerebral infarction and facial capillary malformation

2021 ◽  
pp. 197140092110428
Author(s):  
Trilochan Srivastava ◽  
Ashok Gandhi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebral Infarction ◽  
Rare Case ◽  
Acute Cerebral Infarction ◽  
Resonance Imaging ◽  
Capillary Malformation ◽  
First Case ◽  
Cerebral Vascular Malformation ◽  
Detailed Evaluation ◽  
Weighted Magnetic Resonance Imaging

We are describing a case of a 14-year-old girl who developed acute cerebral infarction which was documented on diffusion-weighted magnetic resonance imaging (DWI). On detailed evaluation, diagnosis of cerebral proliferative angiopathy (CPA) was made. Incidentally, she had capillary malformation on the forehead contralateral to cerebral vascular malformation. To our knowledge, this is the first case of CPA in the literature where DWI abnormality was due to acute cerebral infarction.

scholarly journals Magnetic Resonance Imaging and Clinical Factors Associated With Ischemic Stroke in Patients Suspected of Cervical Artery Dissection

Stroke ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 2337-2344 ◽  
Author(s):  
J. Scott McNally ◽  
Peter J. Hinckley ◽  
Akihiko Sakata ◽  
Laura B. Eisenmenger ◽  
Seong-Eun Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Resonance Imaging ◽  
Clinical Factors ◽  
Factors Associated ◽  
Cervical Artery
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