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.

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.

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.

Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

2019 ◽  
Vol 15 (9) ◽  
pp. 906-910
Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Stable Condition ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cutis Verticis Gyrata ◽  
Essential Form ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.

scholarly journals Alteration within the Hippocampal Volume in Patients with LHON Disease—7 Tesla MRI Study

2020 ◽  
Vol 10 (1) ◽  
pp. 14
Author(s):  
Cezary Grochowski ◽  
Kamil Jonak ◽  
Marcin Maciejewski ◽  
Andrzej Stępniewski ◽  
Mansur Rahnama-Hezavah
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Molecular Layer ◽  
Three Dimensional ◽  
Hippocampal Volume ◽  
7 Tesla ◽  
Diagnostic Process ◽  
Resonance Imaging ◽  
The Right

Purpose: The aim of this study was to assess the volumetry of the hippocampus in the Leber’s hereditary optic neuropathy (LHON) of blind patients. Methods: A total of 25 patients with LHON were randomly included into the study from the national health database. A total of 15 patients were selected according to the inclusion criteria. The submillimeter segmentation of the hippocampus was based on three-dimensional spoiled gradient recalled acquisition in steady state (3D-SPGR) BRAVO 7T magnetic resonance imaging (MRI) protocol. Results: Statistical analysis revealed that compared to healthy controls (HC), LHON subjects had multiple significant differences only in the right hippocampus, including a significantly higher volume of hippocampal tail (p = 0.009), subiculum body (p = 0.018), CA1 body (p = 0.002), hippocampal fissure (p = 0.046), molecular layer hippocampus (HP) body (p = 0.014), CA3 body (p = 0.006), Granule Cell (GC) and Molecular Layer (ML) of the Dentate Gyrus (DG)–GC ML DG body (p = 0.003), CA4 body (p = 0.001), whole hippocampal body (p = 0.018), and the whole hippocampus volume (p = 0.023). Discussion: The ultra-high-field magnetic resonance imaging allowed hippocampus quality visualization and analysis, serving as a powerful in vivo diagnostic tool in the diagnostic process and LHON disease course assessment. The study confirmed previous reports regarding volumetry of hippocampus in blind individuals.

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