Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance
Abstract Background Intracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonan...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12968-021-00766-9 |
| _version_ | 1797203346705088512 |
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| author | Zhang Shi Xia Tian Bing Tian Zakaria Meddings Xuefeng Zhang Jing Li David Saloner Qi Liu Zhongzhao Teng Jianping Lu |
| author_facet | Zhang Shi Xia Tian Bing Tian Zakaria Meddings Xuefeng Zhang Jing Li David Saloner Qi Liu Zhongzhao Teng Jianping Lu |
| author_sort | Zhang Shi |
| collection | DOAJ |
| description | Abstract Background Intracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions. Methods Imaging data from patients who underwent intervention examination or treatment using digital subtraction angiography (DSA) and hrCMR using a 3 T CMR system within 30 days after the onset of neurological symptoms were collected. The CMR protocol included diffusion-weighted imaging (DWI), black blood T1-, T2- and contrast-enhanced T1-weighted sequences. Lesions were classified as culprit and non-culprit according to imaging findings and patient clinical presentations. Univariate and multivariate analyses were performed to assess the difference between culprit and non-culprit lesions and complementary value of hrCMR in identifying higher risk lesions. Results In total, 75 patients were included in this study. According to the morphology, lesions could be classified into five types: Type I, classical dissection (n = 50); Type II, fusiform aneurysm (n = 1); Type III, long dissected aneurysm (n = 3); Type IV, dolichoectatic dissecting aneurysm (n = 9) and Type V, saccular aneurysm (n = 12). Regression analyses showed that age and hypertension were both associated with culprit lesions (age: OR, 0.83; 95% CI 0.75–0.92; p < 0.001 and hypertension: OR, 66.62; 95% CI 5.91–751.11; p = 0.001). Hematoma identified by hrCMR was significantly associated with culprit lesions (OR, 16.80; 95% CI 1.01–280.81; p = 0.037). Moreover, 17 cases (16 lesions were judged to be culprit) were diagnosed as IAD but not visible in DSA and 15 were Type I lesion. Conclusion hrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of IAD. |
| first_indexed | 2024-04-24T08:17:53Z |
| format | Article |
| id | doaj.art-196c8a184c9d4a2cbb5e1b40c16e7cdb |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2024-04-24T08:17:53Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-196c8a184c9d4a2cbb5e1b40c16e7cdb2024-04-17T02:51:06ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2021-06-0123111010.1186/s12968-021-00766-9Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonanceZhang Shi0Xia Tian1Bing Tian2Zakaria Meddings3Xuefeng Zhang4Jing Li5David Saloner6Qi Liu7Zhongzhao Teng8Jianping Lu9Department of Radiology, Changhai Hospital, Naval Medical UniversityDepartment of Radiology, Changhai Hospital, Naval Medical UniversityDepartment of Radiology, Changhai Hospital, Naval Medical UniversityDepartment of Radiology, Addenbrooks’ Hospital, University of CambridgeDepartment of Radiology, Changhai Hospital, Naval Medical UniversityDepartment of Radiology, Changhai Hospital, Naval Medical UniversityDepartment of Radiology and Biomedical Imaging, UCSFDepartment of Radiology, Changhai Hospital, Naval Medical UniversityDepartment of Radiology, Addenbrooks’ Hospital, University of CambridgeDepartment of Radiology, Changhai Hospital, Naval Medical UniversityAbstract Background Intracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions. Methods Imaging data from patients who underwent intervention examination or treatment using digital subtraction angiography (DSA) and hrCMR using a 3 T CMR system within 30 days after the onset of neurological symptoms were collected. The CMR protocol included diffusion-weighted imaging (DWI), black blood T1-, T2- and contrast-enhanced T1-weighted sequences. Lesions were classified as culprit and non-culprit according to imaging findings and patient clinical presentations. Univariate and multivariate analyses were performed to assess the difference between culprit and non-culprit lesions and complementary value of hrCMR in identifying higher risk lesions. Results In total, 75 patients were included in this study. According to the morphology, lesions could be classified into five types: Type I, classical dissection (n = 50); Type II, fusiform aneurysm (n = 1); Type III, long dissected aneurysm (n = 3); Type IV, dolichoectatic dissecting aneurysm (n = 9) and Type V, saccular aneurysm (n = 12). Regression analyses showed that age and hypertension were both associated with culprit lesions (age: OR, 0.83; 95% CI 0.75–0.92; p < 0.001 and hypertension: OR, 66.62; 95% CI 5.91–751.11; p = 0.001). Hematoma identified by hrCMR was significantly associated with culprit lesions (OR, 16.80; 95% CI 1.01–280.81; p = 0.037). Moreover, 17 cases (16 lesions were judged to be culprit) were diagnosed as IAD but not visible in DSA and 15 were Type I lesion. Conclusion hrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of IAD.https://doi.org/10.1186/s12968-021-00766-9Intracranial artery dissectionStrokeCardiovascular magnetic resonanceMRIIntramural hematoma |
| spellingShingle | Zhang Shi Xia Tian Bing Tian Zakaria Meddings Xuefeng Zhang Jing Li David Saloner Qi Liu Zhongzhao Teng Jianping Lu Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance Journal of Cardiovascular Magnetic Resonance Intracranial artery dissection Stroke Cardiovascular magnetic resonance MRI Intramural hematoma |
| title | Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance |
| title_full | Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance |
| title_fullStr | Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance |
| title_full_unstemmed | Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance |
| title_short | Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance |
| title_sort | identification of high risk clinical and imaging features for intracranial artery dissection using high resolution cardiovascular magnetic resonance |
| topic | Intracranial artery dissection Stroke Cardiovascular magnetic resonance MRI Intramural hematoma |
| url | https://doi.org/10.1186/s12968-021-00766-9 |
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