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

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) a...

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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
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cited_by cdi_FETCH-LOGICAL-c594t-592c93f5ac830d68c9e456ac73ee27f6be4fb5d49858dbcbdac7fc74fc5a33eb3
cites cdi_FETCH-LOGICAL-c594t-592c93f5ac830d68c9e456ac73ee27f6be4fb5d49858dbcbdac7fc74fc5a33eb3
container_end_page 74
container_issue 1
container_start_page 74
container_title Journal of cardiovascular magnetic resonance
container_volume 23
creator Shi, Zhang
Tian, Xia
Tian, Bing
Meddings, Zakaria
Zhang, Xuefeng
Li, Jing
Saloner, David
Liu, Qi
Teng, Zhongzhao
Lu, Jianping
description 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 
doi_str_mv 10.1186/s12968-021-00766-9
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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. 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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 &lt; 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. hrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of IAD.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>34120627</pmid><doi>10.1186/s12968-021-00766-9</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2446-4363</orcidid><oa>free_for_read</oa></addata></record>
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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
title Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance
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