Scholarlink

<p><b>Introduction</b>: Vertebrobasilar artery dissection (VBD) results from blood entering a tear in the intima of the vertebral artery (VA), basilar artery (BA), or their branches. T1-Sampling Perfection with Application-optimized Contrast using different flip angle Evolution (T1-SPACE) is a valuable tool for detecting intramural hematoma (IMH). Despite its potential, clinical adoption of susceptibility-weighted imaging (SWI) remains limited. This study aimed to clarify the usefulness of SWI and T1-SPACE for detecting IMH in VBD. </p><p><b>Methods</b>: Consecutive patients admitted with symptomatic VBD within 28 days of onset between November 2014 and September 2023 were retrospectively screened from the Jikei University School of Medicine Stroke Registry. Inclusion criteria were definitive VBD diagnosis based on Spontaneous Cervicocephalic Arterial Dissections Study criteria and simultaneous acquisition of SWI and T1-SPACE. IMH detectability was compared between the two sequences. </p><p><b>Results</b>: The study included 74 patients (52 males; median age, 45 years). IMH detection rates showed no significant difference between two sequences. The detection rate of IMH on SWI was relatively low in extracranial VA compared to intracranial VA or BA and PICA (3/8 vs. 62/66, <i>p</i> &lt; 0.001), whereas on T1-SPACE, IMH was consistently detected in extracranial VA and intracranial VA or BA but was markedly lower in PICA (1/7 vs. 65/67, <i>p</i> &lt; 0.001). Time from symptom onset to detection was similar across groups. </p><p><b>Conclusions</b>: SWI demonstrated limited sensitivity for detecting IMH in extracranial VA, whereas T1-SPACE was less effective in PICA. Considering the site-specific differences in the culprit vessel, the combined use of both sequences may enhance diagnostic accuracy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The essential role of multimodal magnetic resonance imaging in diagnosing vertebrobasilar artery dissection

  • 期刊论文

  • 发表日期：

    2025年9月16日

查看全文
  • Yoshitaka Nakayama,
  • Teppei Komatsu,
  • Motohiro Okumura,
  • Hiroyuki Kida,
  • Ryoji Nakada,
  • Tomomichi Kitagawa,
  • Hiroki Takatsu,
  • Kenichi Sakuta,
  • Kenichiro Sakai,
  • Hidetaka Mitsumura,
  • Yasuyuki Iguchi

摘要

Introduction: Vertebrobasilar artery dissection (VBD) results from blood entering a tear in the intima of the vertebral artery (VA), basilar artery (BA), or their branches. T1-Sampling Perfection with Application-optimized Contrast using different flip angle Evolution (T1-SPACE) is a valuable tool for detecting intramural hematoma (IMH). Despite its potential, clinical adoption of susceptibility-weighted imaging (SWI) remains limited. This study aimed to clarify the usefulness of SWI and T1-SPACE for detecting IMH in VBD.

Methods: Consecutive patients admitted with symptomatic VBD within 28 days of onset between November 2014 and September 2023 were retrospectively screened from the Jikei University School of Medicine Stroke Registry. Inclusion criteria were definitive VBD diagnosis based on Spontaneous Cervicocephalic Arterial Dissections Study criteria and simultaneous acquisition of SWI and T1-SPACE. IMH detectability was compared between the two sequences.

Results: The study included 74 patients (52 males; median age, 45 years). IMH detection rates showed no significant difference between two sequences. The detection rate of IMH on SWI was relatively low in extracranial VA compared to intracranial VA or BA and PICA (3/8 vs. 62/66, p < 0.001), whereas on T1-SPACE, IMH was consistently detected in extracranial VA and intracranial VA or BA but was markedly lower in PICA (1/7 vs. 65/67, p < 0.001). Time from symptom onset to detection was similar across groups.

Conclusions: SWI demonstrated limited sensitivity for detecting IMH in extracranial VA, whereas T1-SPACE was less effective in PICA. Considering the site-specific differences in the culprit vessel, the combined use of both sequences may enhance diagnostic accuracy.