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Ma W, Zhou K, Lan B, Chen K, Li W, Jiang G. Imaging investigation of cervicocranial artery dissection by using high resolution magnetic resonance VWI and MRA: qualitative and quantitative analysis at different stages. BMC Med Imaging 2023; 23:184. [PMID: 37957581 PMCID: PMC10644659 DOI: 10.1186/s12880-023-01133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND To explore the value of magnetic resonance angiography (MRA) and high resolution magnetic resonance vessel wall imaging (HRMR-VWI) in cervicocranial artery dissection (CCAD) for the disease diagnosis, course staging and treatment. On the basis of qualitative evaluation, this study also extract the changes of different stages in vessel wall in different vessel segments to identify imaging indicators for the quantitative evaluation of CCAD. METHODS We retrospectively enrolled 34 patients with CCAD (38branches) with conventional MRA and HRMR-VWI examinations. Two radiologists independently analyzed imaging features of vessel wall and lumen in the different stages, and the typical sign detection of artery dissection were compared between MRA and HRMR-VWI. Then the parameters of vessel wall was quantitatively evaluated by the post-processing software (Vesselmass, Leiden University Medical Center, Leiden, The Netherlands. RESULTS HRMR-VWI revealed typical sign detection of artery dissection in all patients in the acute and subacute stage. Among them, the intimal flap/double lumen sign ditection were more common than the MRA, there was significant difference (P = 0.012). MRA revealed typical sign detection of artery dissection in more than half the patients, and the detection was no significant difference at the chronic stage between MRA and HRMR-VWI (P = 1.000/1.000/0.761). In the acute and subacute stage, the typical sign detection of intramural hematoma and Grade II enhancement revealed by HR-MRI was higher than the observations in the chronic stage (P = 0.000/0.000/0.016), while there was no significant difference by MRA (P = 0.902). The values of wall thickness, relative signal intensity of vessel wall enhancement, relative signal intensity of intramural hematoma (IMH), and percentage of stenosis in CCAD decreased from acute to subacute and then to chronic stages. Each quantitative parameter in patients with CCAD in the early stages (i.e., acute and subacute stages) was significantly different from that in patients with CCAD in the recovered group at chronic stage (P < 0.05). Wall thickness and relative signal intensity of vessel wall enhancement in patients with CCAD in the early stages were not significantly different from those in patients with CCAD in the incompletely recovered group at chronic stage (P > 0.05). CONCLUSIONS As the only noninvasive imaging technology, HRMR-VWI displays the structure of the vessel wall in vivo, showing not only excellent performance in the early diagnosis of CCAD, but also describing the changes of different stages in the qualitative and quantitative characteristics of vessel wall. It also helps to guide the diseasediagnosis, course staging and treatment of CCAD. Although the diagnostic efficacy of MRA was not as good as HRMR-VWI, it should be the first choice of method for routine examination in evaluating CCAD, especially at the chronic stage of CCAD.
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Affiliation(s)
- Weiqiong Ma
- The Second School of Clinical Medicine, Southern Medical University, NO.1023 North Road of Shatai, Baiyun District, Guangzhou, Guangdong, China
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, NO.1 Road of Shiliugang, Haizhu District, Guangzhou, Guangdong, China
- Department of Radiology, Huizhou Central People's Hospital, NO.41 North Road of Eling, Huicheng District, Huizhou, Guangdong, China
| | - Kexin Zhou
- The Second School of Clinical Medicine, Southern Medical University, NO.1023 North Road of Shatai, Baiyun District, Guangzhou, Guangdong, China
| | - Bowen Lan
- Department of Radiology, Huizhou Central People's Hospital, NO.41 North Road of Eling, Huicheng District, Huizhou, Guangdong, China
| | - Kangyin Chen
- Department of Radiology, Huizhou Central People's Hospital, NO.41 North Road of Eling, Huicheng District, Huizhou, Guangdong, China
| | - Wuming Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, NO.1 Road of Shiliugang, Haizhu District, Guangzhou, Guangdong, China
| | - Guihua Jiang
- The Second School of Clinical Medicine, Southern Medical University, NO.1023 North Road of Shatai, Baiyun District, Guangzhou, Guangdong, China.
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, NO.1 Road of Shiliugang, Haizhu District, Guangzhou, Guangdong, China.
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Peret A, Romero-Sanchez G, Dabiri M, McNally JS, Johnson KM, Mossa-Basha M, Eisenmenger LB. MR Angiography of Extracranial Carotid Disease. Magn Reson Imaging Clin N Am 2023; 31:395-411. [PMID: 37414468 DOI: 10.1016/j.mric.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Magnetic resonance angiography sequences, such as time-of-flight and contrast-enhanced angiography, provide clear depiction of vessel lumen, traditionally used to evaluate carotid pathologic conditions such as stenosis, dissection, and occlusion; however, atherosclerotic plaques with a similar degree of stenosis may vary tremendously from a histopathological standpoint. MR vessel wall imaging is a promising noninvasive method to evaluate the content of the vessel wall at high spatial resolution. This is particularly interesting in the case of atherosclerosis as vessel wall imaging can identify higher risk, vulnerable plaques as well as has potential applications in the evaluation of other carotid pathologic conditions.
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Affiliation(s)
- Anthony Peret
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53705, USA
| | - Griselda Romero-Sanchez
- Department of Radiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan C.P.14080, Ciudad de México, Mexico City, Mexico
| | - Mona Dabiri
- Radiology Department, Children's Medical Center, Tehran University of Medical Science, No 63, Gharib Avenue, Keshavarz Blv, Tehran 1419733151, Iran
| | - Joseph Scott McNally
- Department of Radiology, University of Utah, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53705, USA
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA
| | - Laura B Eisenmenger
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53705, USA.
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Wu Y, Wu F, Liu Y, Fan Z, Fisher M, Li D, Xu W, Jiang T, Cheng J, Sun B, Ji X, Yang Q. High-Resolution Magnetic Resonance Imaging of Cervicocranial Artery Dissection: Imaging Features Associated With Stroke. Stroke 2019; 50:3101-3107. [PMID: 31514693 DOI: 10.1161/strokeaha.119.026362] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- We aimed to systematically investigate the characteristics of cervicocranial artery dissection (CCAD) on high-resolution magnetic resonance imaging that are associated with acute ischemic stroke. Methods- Patients with CCAD were recruited and divided into stroke and nonstroke groups. The lesion location, the presence of a double lumen, intimal flap, intramural hematoma, pseudoaneurysm, irregular surface, intraluminal thrombus, and other quantitative parameters of each dissected segment were reviewed. Multiple logistic regression was used to examine the association between imaging features of CCAD and ischemic stroke. Results- A total of 145 affected vessels from 118 patients with CCAD were analyzed. Anterior circulation, intramural hematoma, irregular surface, intraluminal thrombus, and severe stenosis (>70%) on high-resolution magnetic resonance imaging were more prevalent in CCAD patient with stroke (54.4% versus 36.4%; P=0.030, 96.2% versus 84.8%; P=0.017, 74.7% versus 37.9%; P<0.001, 44.3% versus 4.5%; P<0.001, and 54.4% versus 31.8%; P=0.008, respectively). In multivariable logistic regression analysis, the presence of irregular surface and intraluminal thrombus on imaging were independently associated with acute ischemic stroke in CCAD with odds ratios of 4.29 (95% CI, 1.61-11.46, P=0.004) and 7.48 (95% CI, 1.64-34.07, P=0.009). Conclusions- The current findings supported that the presence of irregular surface and intraluminal thrombus were related to stroke occurrence in patients with CCAD. High-resolution magnetic resonance imaging might give insights into pathogenesis of ischemic stroke in CCAD. It may be useful for individual prediction of ischemic stroke early in CCAD.
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Affiliation(s)
- Ye Wu
- From the Departments of Radiology (Y.W., F.W., Y.L., Q.Y.), Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fang Wu
- From the Departments of Radiology (Y.W., F.W., Y.L., Q.Y.), Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuehong Liu
- From the Departments of Radiology (Y.W., F.W., Y.L., Q.Y.), Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA (Z.F., D.L.)
| | - Marc Fisher
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA (M.F.)
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA (Z.F., D.L.)
| | - Weihai Xu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (W.X.)
| | - Tao Jiang
- Department of Radiology, Chaoyang Hospital, Capital Medical University, Beijing, China (T.J.)
| | - Jingliang Cheng
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, China (J.C.)
| | - Bin Sun
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China (B.S.)
| | - Xunming Ji
- Neurosurgery (X.J.), Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qi Yang
- From the Departments of Radiology (Y.W., F.W., Y.L., Q.Y.), Xuanwu Hospital, Capital Medical University, Beijing, China
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