Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance

• Published in: Journal of cardiovascular magnetic resonance 2021-06, Vol.23 (1), p.74-74, Article 74
• Main Authors: Shi, Zhang, Tian, Xia, Tian, Bing, Meddings, Zakaria, Zhang, Xuefeng, Li, Jing, Saloner, David, Liu, Qi, Teng, Zhongzhao, Lu, Jianping
• Format: Article
• Language: English
• Subjects: Aneurysm; Aneurysms; Angiography; Aortic Dissection - diagnostic imaging; Arteries; Atherosclerosis; Blood circulation disorders; Cardiovascular magnetic resonance; Care and treatment; Diabetes; Diagnostic imaging; Digital imaging; Dissection; Drunk driving; Hematoma; High resolution; Humans; Hypertension; Image resolution; Intracranial artery dissection; Intramural hematoma; Ischemia; Lesions; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Medical imaging; Medical research; Medicine, Experimental; Morphology; MRI; Patients; Predictive Value of Tests; Reproducibility; Resonance; Risk; Saccule; Statistical analysis; Stroke; Surgery; Transient ischemic attack; Veins & arteries
• ISSN: 1097-6647; 1532-429X
• DOI: 10.1186/s12968-021-00766-9

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. 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. 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