MRI of intracranial vertebral artery dissection: evaluation of intramural haematoma using a black blood, variable-flip-angle 3D turbo spin-echo sequence

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• 作者：Koichi Takano (1)
  Shinnichi Yamashita (1)
  Koichiro Takemoto (2)
  Tooru Inoue (2)
  Yasuo Kuwabara (1)
  Kengo Yoshimitsu (1)
  
• 关键词：Vertebral artery dissection ; Magnetic resonance imaging ; MR angiography ; Three dimensional ; Black blood
• 刊名：Neuroradiology
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：55
• 期：7
• 页码：845-851
• 全文大小：291KB
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• 作者单位：Koichi Takano (1)
  Shinnichi Yamashita (1)
  Koichiro Takemoto (2)
  Tooru Inoue (2)
  Yasuo Kuwabara (1)
  Kengo Yoshimitsu (1)
  
  1. Department of Radiology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka, 814-0180, Japan
  2. Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
  

文摘

Introduction We investigated the efficacy of three-dimensional black blood T1-weighted imaging (3D-BB-T1WI) using a variable refocusing flip angle turbo spin-echo sequence in the diagnosis of intracranial vertebral artery dissection (VAD). Methods Sixteen consecutive patients diagnosed with intracranial VAD underwent magnetic resonance imaging that included 3D time-of-flight-MRA, axial spin-echo T1-weighted images (SE-T1WI) and oblique coronal 3D-BB-T1WI sequences. The visualization, morphology and extent of intramural haematomas were assessed and compared among the sequences. Results obtained by digital subtraction angiography (DSA), 3D-angiography and/or 3D-CT angiography (CTA) were used as standards of reference. Results 3D-BB-T1WI revealed intramural haematomas in all cases, whereas SE-T1WI and magnetic resonance angiography (MRA) failed to reveal a haematoma in one case and three cases, respectively. The mean visualization grading score for the intramural haematoma was the highest for 3D-BB-T1WI, and there was a statistically significant difference among the sequences (p-lt;-.001). At least a portion of the intramural haematoma was distinguishable from the lumen on 3D-BB-T1WI, whereas the haematomas were entirely indistinguishable from intraluminal signals on MRA in two cases (12.5?%) and on SE-T1WI in one case (6.3?%). 3D-BB-T1WI revealed the characteristic crescent shape of the intramural haematoma in 14 cases (87.5?%), whereas SE-T1WI and MRA revealed a crescent shape in only 7 cases (43.8?%) and 8 cases (50?%), respectively. In a consensus reading, 3D-BB-T1WI was considered the most consistent sequence in representing the extent and morphology of the lesion in 14 cases (87.5?%), compared to DSA and CTA. Conclusion 3D-BB-T1WI is a promising method to evaluate intramural haematoma in patients with suspected intracranial VAD.