scholarly journals Magnetic resonance imaging in the diagnosis of the outcomes of brachiocephalic artery dissection

2021 ◽  
Vol 12 (2) ◽  
pp. 92-97
Author(s):  
T. A. Lesnykh ◽  
M. V. Dreval’ ◽  
M. S. Danilova ◽  
M. A. Kravchenko ◽  
L. А. Kalashnikova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Vessel Wall ◽  
Artery Dissection ◽  
Brachiocephalic Artery ◽  
Resonance Imaging ◽  
Double Lumen ◽  
Aneurysmal Dilation ◽  
Before And After ◽  
Wall Imaging

Introduction. Vessel wall imaging in patients with dissection plays an impotent role in the differential diagnosis of stenoocclusive processes of the main arteries of the head. However, the interpretation of changes in long-term periods remains difficulties. Purpose: to determine and compare the imaging patterns of the consequences of the postponed dissection using MRI and ultrasound.Materials and methods. 30 patients with confirmed dissection were examined for more than 1 year from the date of diagnosis. MRI was performed using vessel wall protocol imaging before and after contrast enhancement.Results. Postpone dissection imaging patterns were revealed: aneurysmal dilation of the artery (27%) and double lumen (20%) at the site of dissection; prolonged stenosis in 10% of cases, intimal flap — in 3% of cases. Occlusion persisted in 40% of cases.Conclusion. The use of MRI can improve the differential diagnosis of the causes of the stenоocclusive process of the main arteries of the head.

Abstract 108: Additional Value of Intracranial Vessel Wall Imaging to Determine the Etiology of Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joanna D Schaafsma ◽  
David J Mikulis ◽  
Jonathan Coutinho ◽  
Cheryl S Jaigobin ◽  
Daniel M Mandell
Keyword(s):  
Differential Diagnosis ◽  
Ischemic Stroke ◽  
Vessel Wall ◽  
Stroke Work ◽  
Standard Work ◽  
Additional Information ◽  
Stroke Etiology ◽  
Additional Value ◽  
Work Up ◽  
Wall Imaging

Objective: High-resolution MR-imaging of the intracranial arterial wall is a promising technique for diagnosis of intracranial arteriopathies in patients with ischemic stroke. We aimed to evaluate the additional value of vessel wall imaging (VWI) to the standard work-up of ischemic stroke patients. Methods: We selected all patients with ischemic stroke who had intracranial VWI at our institute to evaluate possible intracranial arteriopathy, such as atherosclerosis, dissection, vasculitis, or reversible cerebral vasoconstriction syndrome. Two observers, who were blinded to the VWI, first determined the most likely stroke etiology based on the standard work-up (clinical history, brain parenchyma imaging, vessel lumen imaging, laboratory results, and cardiac work-up). Then VWI was reviewed to assess whether this would change the suspected stroke etiology or whether the differential diagnosis could be narrowed down. Results: Between 2006 and 2014, 199 patients with ischemic stroke, mean age 55 (IQ-range: 44-67) had VWI. VWI provided additional information to the standard stroke work-up in 128 patients (64%). In 38/199 patients (19%) the conclusion on stroke etiology was altered based on VWI and in 90/199 patients (45%) the differential diagnosis was further narrowed after VWI. VWI did not have additional value when the most likely stroke etiology based on the standard work-up remained the same (50/199 patients; 25%), when the differential diagnosis could not be narrowed down (16/199; 8%), or in case of poor image quality (5/199 patients; 3%). Patients under the age of 46 benefited more often from VWI than older adults (Odds Ratio 3.5; 95%CI: 1.7-7.6). Conclusion: VWI provided additional information to the conventional stroke work-up in almost two-thirds of patients suspected to have intracranial arteriopathy. Next step is to determine how frequently this additional information resulted in altered therapy.

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 The effect of capped biparametric magnetic resonance imaging slots on weekly prostate cancer imaging workload

2020 ◽  
Vol 93 (1108) ◽  
pp. 20190929 ◽  
Author(s):  
Nikita Sushentsev ◽  
Iztok Caglic ◽  
Evis Sala ◽  
Nadeem Shaida ◽  
Rhys A Slough ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Mean Absolute Deviation ◽  
Resonance Imaging ◽  
Absolute Deviation ◽  
Intergroup Comparison ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Objective: To introduce capped biparametric (bp) MRI slots for follow-up imaging of prostate cancer patients enrolled in active surveillance (AS) and evaluate the effect on weekly variation in the number of AS cases and total MRI workload. Methods: Three 20 min bpMRI AS slots on two separate days were introduced at Addenbrooke’s Hospital, Cambridge. The weekly numbers of total prostate MRIs and AS cases recorded 15 months before and after the change (Groups 1 and 2, respectively). An intergroup variation in the weekly scan numbers was assessed using the coefficient of variance (CV) and mean absolute deviation; the Mann–Whitney U test was used for an intergroup comparison of the latter. Results: In AS patients, a shift from considerable to moderate variation in weekly scan numbers was observed between the two groups (CV, 51.7 and 26.8%, respectively); mean absolute deviation of AS scans also demonstrated a significant decrease in Group 2 (1.28 vs 2.58 in Group 1; p < 0.001). No significant changes in the variation in total prostate MRIs were observed, despite a 10% increased workload in Group 2. Conclusion: A significant reduction in weekly variation of AS cases was demonstrated following the introduction of capped bpMRI slots, which can be used for more accurate long-term planning of MRI workload. Advances in knowledge: The paper illustrates the potential of introducing capped AS MRI slots using a bp protocol to reduce weekly variation in demand and allow for optimising workflow, which will be increasingly important as the demands on radiology departments increase worldwide.

scholarly journals Correlating Hemodynamic Magnetic Resonance Imaging with high-field Intracranial Vessel Wall Imaging in Stroke

2014 ◽  
Vol 8 (6) ◽  
Author(s):  
Weston Langdon ◽  
Manus J. Donahue ◽  
Anja Gwendolyn Van der Kolk ◽  
Swati Rane ◽  
Megan K Strother
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vessel Wall ◽  
High Field ◽  
Vessel Wall Imaging ◽  
Resonance Imaging ◽  
Intracranial Vessel ◽  
Wall Imaging

scholarly journals Image Findings of Acute to Subacute Craniocervical Arterial Dissection on Magnetic Resonance Vessel Wall Imaging: A Systematic Review and Proportion Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Se Jin Cho ◽  
Byung Se Choi ◽  
Yun Jung Bae ◽  
Sung Hyun Baik ◽  
Leonard Sunwoo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Magnetic Resonance ◽  
Vessel Wall ◽  
Meta Analysis ◽  
Vessel Wall Imaging ◽  
Arterial Dissection ◽  
Double Lumen ◽  
Intimal Flap ◽  
Ovid Medline ◽  
Wall Imaging

Background and Purpose: This systematic review and meta-analysis aimed to evaluate the pooled proportion of image findings of acute to subacute craniocervical arterial dissection (AD) direct signs on magnetic resonance vessel wall imaging (MR-VWI) and to identify factors responsible for the heterogeneity across the included studies.Methods: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies published on the relevant topic before April 14, 2020. Pooled sensitivity and specificity values and their 95% confidence intervals (CIs) were calculated using bivariate random-effects modeling. Meta-regression analyses were also performed to determine factors influencing heterogeneity.Results: Eleven articles with data for 209 patients with acute to subacute craniocervical AD who underwent MR-VWI were included in this systematic review and meta-analysis. The most common findings on MR-VWI were wall hematoma (84%; 95% CI, 71%−92%), abnormal enhancement (72%; 95% CI, 49%−88%), aneurysmal dilatation (71%, 95% CI, 53%−84%), and intimal flap or double lumen signs (49%; 95% CI, 29%−71%). Among the potential covariates of heterogeneity, the presence of contrast-enhanced T1-weighted imaging (CE-T1WI) within the MR-VWI sequence combination significantly affected the pooled proportion of the intimal flap or double lumen signs.Conclusion: Wall hematoma and intimal flap or double lumen signs were the most common and least common direct sign image findings, respectively, on MR-VWI in patients with acute to subacute craniocervical AD. Furthermore, the absence of CE-T1WI in MR-VWI protocol was the cause of heterogeneity for the detection of the intimal flap or double lumen signs. This data may help improve MR-VWI interpretation and enhance the understanding of the radiologic diagnosis of craniocervical AD.

scholarly journals Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms

2019 ◽  
Author(s):  
Xianjin Zhu ◽  
Hancheng Qiu ◽  
Ferdinand K Hui ◽  
Yiqun Zhang ◽  
Yun-e Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Three Dimensional ◽  
Vessel Wall Imaging ◽  
Catheter Angiography ◽  
Double Lumen ◽  
Post Contrast ◽  
Dissecting Aneurysms ◽  
Wall Imaging

Abstract Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs. Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). The lesion was diagnosed as definite VBDA when presenting direct signs of dissection; as possible when only presenting indirect signs; and as segmental ectasia when there was local dilation and wall thickness similar to adjacent normal artery’s without mural thrombosis. Results: Twenty-one patients with 27 lesions suspicious for VBDAs were finally included. Based on findings of VWI and catheter angiography, definite VBDA was diagnosed in 25 and 7 lesions (92.6%, vs 25.9%, p = 0.000), respectively; possible VBDA in 0 and 20 (0 vs 74.1%), respectively; and segmental ectasia in 2 and 0 (7.4% vs 0%), respectively. On VWI and catheter angiography, intimal flap was detected in 21 and 7 lesions (77.8% vs 25.9%, p=0.001), respectively; double lumen sign in 18 and 7 (66.7% vs 25.9%, p=0.003), respectively; and IMH sign in 14 and 0 (51.9% vs 0), respectively. Conclusions: 3D HRMR VWI was superior to catheter angiography in achieving definite diagnosis of intracranial VBDAs with higher rate of detection of direct dissection signs; and allowed a promising way to differentiate between VBDA and segmental ectasia.

Multi-Contrast High-Resolution Magnetic Resonance Findings of Spontaneous and Unruptured Intracranial Vertebral Artery Dissection: Qualitative and Quantitative Analysis According to Stages

2016 ◽  
Vol 42 (1-2) ◽  
pp. 23-31 ◽  
Author(s):  
Kye Jin Park ◽  
Seung Chai Jung ◽  
Ho Sung Kim ◽  
Choong-Gon Choi ◽  
Sang Joon Kim ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Vertebral Artery Dissection ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Radiological Findings ◽  
Double Lumen ◽  
Aneurysmal Dilatation ◽  
Chronic Stage ◽  
Relative Signal Intensity ◽  
Qualitative And Quantitative

Background: Although high-resolution magnetic resonance imaging (HR-MRI) has been used as a strong imaging method for diagnosing intracranial vertebral artery dissection (IVAD), the diagnosis is sometimes challenging because a dissection has geometric changes in the natural course. The radiologic features may change or disappear over time, which makes the diagnosis confusing. Our study was to present radiological findings according to the stages in spontaneous and unruptured, IVAD on 3T HR-MRI and to guide the age estimation of IVAD with the distinguishing findings according to the stages. Methods: From January 2011 to July 2014, the 41 vertebral arteries (M:F = 18:12; age range 32-67 years) were retrospectively enrolled. Spontaneous, unruptured IVAD was diagnosed if it had a clear onset based on clinical and radiological findings. The stages were classified as acute (0-3 days), early subacute (3-10 days), late subacute (10-60 days) and chronic stage (>60 days; recovery and non-recovery groups) according to the time intervals from symptom onset, based on the prior published studies. HR-MR findings were assessed and compared in the intimal flap, double lumen, aneurysmal dilatation (maximal outer diameter, maximal wall thickness, wall thickness index and remodeling index), intramural hematoma (relative signal intensity) and vessel wall enhancement according to the stages with qualitative and quantitative methods. Two radiologists analyzed the HR-MR findings with consensus reading. Results: IVAD was classified into acute (n = 6), early subacute (n = 8), late subacute (n = 16) and chronic (n = 11) stages. HR-MR dissection findings such as intimal flap, double lumen, aneurysmal dilatation and intramural hematoma significantly decreased from the earlier stages to the chronic stage (p < 0.05). The quantitative indices in aneurysmal dilatation and the relative signal intensity of intramural hematoma showed significant higher values in the earlier stages followed by a significant decrease in the chronic stage recovery group (p < 0.05). The degree of vessel wall enhancement was higher in the earlier stage and decreased in the chronic stage (p < 0.05), but mild vessel wall enhancement was identified 900 days after symptom onset. Conclusion: The 3T HR-MRI reveals the vessel wall characteristics and provides distinguishing findings between earlier stages and the chronic stage in spontaneous and unruptured IVAD. Characterization of these radiological findings according to stages may assist with the age estimation of the dissection and may help to understand IVAD as a whole.

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