척추동맥 박리 진단에 대한 혈관벽 영상의 유용성

Abstract

Usefulness of high resolution vessel wall MR imaging for the diagnosis of vertebral artery dissection

Objective : The aim of this study was to evaluate usefulness of high resolution vessel wall MR imaging for the diagnosis of vertebral artery dissection.

Methods : We retrospectively reviewed 44 patients (male:female = 35:9, mean age = 54 years, 23-85years) who underwent high resolution vessel wall MR imaging (HR-VWI) and conventional MR and MR angiography. Patients with a history of trauma were excluded. One experienced stroke neurologist diagnosed patients as either vertebral artery dissection (VAD) and non-vertebral artery dissection (non-VAD). High resolution vessel wall MR imagings were evaluated retrospectively by one neuroradiologist for the presence of acute dissection signs (crescentic high signal intramural hematoma, and double lumen or intimal flap). When one or more of acute dissection signs was demonstrated on imaging studies, vertebral artery dissection sign was positive. HR-VWI findings were compared among two groups (VAD and non-VAD). The MR angiographic shapes of vertebral artery dissections were subdivided into three types: (a) occlusion,(b) stenosis and (c) dilation and stenosis )

Results : In 20/22 patients in VAD group, HR-VWI demonstrated one or more of acute vertebral artery dissection signs (intramural hematoma, intimal flap or double lumen). In 4/22 patients in non-VAD group, HR-VWI demonstrated one or more of acute vertebral artery dissections signs. 27 vertebral artery dissection lesions in 24 patients were revealed on HR-VWI. Type a was 14 lesions, type b was 10, type c was 3.

Conclusion : High resolution vessel wall MR imaging can be a useful and non-invasive diagnostic tool in the event of suspicion of symptomatic vertebral artery dissection.