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Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms
Xianjin Zhu
China-Japan Friendship Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9647-8855
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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 < 0.001), 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 could detect direct dissection signs more frequently than catheter angiography. This may help obtain definite diagnosis of intracranial VBDAs, and allow accurate differentiation between dissecting aneurysm and segmental ectasia as well. Further prospective study with larger sample was required to investigate the superiority of HRMR VWI for definite diagnosis of intracranial VBDAs than catheter angiography
Keywords
Dissecting aneurysm; Vertebrobasilar artery; High resolution magnetic resonance image; Vessel wall imaging
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CURRENT STATUS: Under Review
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Posted 14 May, 2020
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Submission checks complete
On 19 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 16 Apr, 2020
Review #1 received
Received 24 Mar, 2020
Reviewer #1 agreed
On 13 Mar, 2020
Reviewers invited
Invitations sent on 12 Mar, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
No comments provided
Editorial decision: Major revision
On 26 Nov, 2019
Review #1 received
Received 10 Nov, 2019
Reviewer #2 agreed
On 25 Oct, 2019
Reviewer #1 agreed
On 23 Oct, 2019
Reviewers invited
Invitations sent on 15 Oct, 2019
Editor assigned
On 19 Sep, 2019
Submission checks complete
On 18 Sep, 2019
Editor invited
On 18 Sep, 2019
No comments provided
Review #2 received
Received 21 Aug, 2019
Editorial decision: Major revision
On 21 Aug, 2019
Review #1 received
Received 09 Aug, 2019
Reviewer #2 agreed
On 06 Aug, 2019
Reviewers invited
Invitations sent on 30 Jul, 2019
Reviewer #1 agreed
On 30 Jul, 2019
Submission checks complete
On 19 Jul, 2019
Editor assigned
On 11 Jul, 2019
Editor invited
On 10 Jul, 2019
First submitted
On 09 Jul, 2019
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This preprint is under consideration at BMC Neurology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms
Xianjin Zhu
China-Japan Friendship Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9647-8855
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 4
Posted 14 May, 2020
No community comments so far
Submission checks complete
On 19 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 16 Apr, 2020
Review #1 received
Received 24 Mar, 2020
Reviewer #1 agreed
On 13 Mar, 2020
Reviewers invited
Invitations sent on 12 Mar, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
No comments provided
Editorial decision: Major revision
On 26 Nov, 2019
Review #1 received
Received 10 Nov, 2019
Reviewer #2 agreed
On 25 Oct, 2019
Reviewer #1 agreed
On 23 Oct, 2019
Reviewers invited
Invitations sent on 15 Oct, 2019
Editor assigned
On 19 Sep, 2019
Submission checks complete
On 18 Sep, 2019
Editor invited
On 18 Sep, 2019
No comments provided
Review #2 received
Received 21 Aug, 2019
Editorial decision: Major revision
On 21 Aug, 2019
Review #1 received
Received 09 Aug, 2019
Reviewer #2 agreed
On 06 Aug, 2019
Reviewers invited
Invitations sent on 30 Jul, 2019
Reviewer #1 agreed
On 30 Jul, 2019
Submission checks complete
On 19 Jul, 2019
Editor assigned
On 11 Jul, 2019
Editor invited
On 10 Jul, 2019
First submitted
On 09 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 < 0.001), 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 could detect direct dissection signs more frequently than catheter angiography. This may help obtain definite diagnosis of intracranial VBDAs, and allow accurate differentiation between dissecting aneurysm and segmental ectasia as well. Further prospective study with larger sample was required to investigate the superiority of HRMR VWI for definite diagnosis of intracranial VBDAs than catheter angiography
Figure 1
Figure 2
Figure 3