Magnetic resonance angiographic and clinical features of extracranial vertebral artery dissection

被引:89
作者
Auer, F
Felber, S
Schmidauer, C
Waldenberger, P
Aichner, F
机构
[1] Univ Innsbruck, Dept Magnet Resonance, A-6020 Innsbruck, Austria
[2] Univ Innsbruck, Dept Radiol, A-6020 Innsbruck, Austria
[3] Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, Austria
关键词
vertebral artery dissection; angiography; magnetic resonance angiography; ultrasound;
D O I
10.1136/jnnp.64.4.474
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives-Clinical data and neuroradiological findings of 19 patients with 20 vertebral artery dissections were analysed to describe the features of time of flight magnetic resonance angiography (MRA) for the diagnosis and follow up of this vascular disorder. Methods-All patients underwent a combined MRI and MRA protocol with 1.5 T scanners, using a three dimensional flow compensated gradient echo sequence for MRA, Duplex sonography was performed on all patients and selective angiography was available from 17 vertebral artery dissections. Results-MRI showed ischaemic lesions of the brain in 18 of 19 patients (95%). in the acute and subacute stage, MRA detected signal abnormalities within the dissected vertebral artery in 94% (16/17) and MRI was specific for a dissection in 29% (5/17). Sensitivity of selective angiography was 100% and specificity was 35% (6/17). Combination of the results of bath methods increased the specificity to 50%. Duplex sonography was sensitive in 79% (15/19), but lacked specific results. Follow up magnetic resonance in 16 patients showed recanalisation of the dissected vessel in 10 (63%), persistent occlusion in five (31%), and a dissecting aneurysm in one (6%) patient. Conclusions-Magnetic resonance improves the triage for selective angiography and discloses complementary information for the diagnosis of vertebral artery dissection. if magnetic resonance identifies a double lumen or a mural haematoma with a stenosis or aneurysmal dilatation, invasive procedures can be omitted.
引用
收藏
页码:474 / 481
页数:8
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