Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms
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
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Posted 14 May, 2020
On 19 Jul, 2019
On 16 Apr, 2020
Received 24 Mar, 2020
On 13 Mar, 2020
Invitations sent on 12 Mar, 2020
On 06 Feb, 2020
On 05 Feb, 2020
On 05 Feb, 2020
On 26 Nov, 2019
Received 10 Nov, 2019
On 25 Oct, 2019
On 23 Oct, 2019
Invitations sent on 15 Oct, 2019
On 19 Sep, 2019
On 18 Sep, 2019
On 18 Sep, 2019
Received 21 Aug, 2019
On 21 Aug, 2019
Received 09 Aug, 2019
On 06 Aug, 2019
Invitations sent on 30 Jul, 2019
On 30 Jul, 2019
On 19 Jul, 2019
On 11 Jul, 2019
On 10 Jul, 2019
On 09 Jul, 2019
Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms
Posted 14 May, 2020
On 19 Jul, 2019
On 16 Apr, 2020
Received 24 Mar, 2020
On 13 Mar, 2020
Invitations sent on 12 Mar, 2020
On 06 Feb, 2020
On 05 Feb, 2020
On 05 Feb, 2020
On 26 Nov, 2019
Received 10 Nov, 2019
On 25 Oct, 2019
On 23 Oct, 2019
Invitations sent on 15 Oct, 2019
On 19 Sep, 2019
On 18 Sep, 2019
On 18 Sep, 2019
Received 21 Aug, 2019
On 21 Aug, 2019
Received 09 Aug, 2019
On 06 Aug, 2019
Invitations sent on 30 Jul, 2019
On 30 Jul, 2019
On 19 Jul, 2019
On 11 Jul, 2019
On 10 Jul, 2019
On 09 Jul, 2019
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