Document Detail


Preliminary experience using contrast-enhanced MR angiography to assess vertebral artery structure for the follow-up of suspected dissection.
MedLine Citation:
PMID:  10512235     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Important advances have been made recently in MR angiography with the use of contrast medium injection, which has proved valuable for the imaging of vertebral arteries (VAs) obtained during short scanning times. Our purpose was to assess the feasability of contrast-enhanced fast 3D MR angiography for imaging VAs and to evaluate the long-term follow-up of VA dissections. METHODS: Sixteen consecutive patients with 18 angiographically documented VA dissections (seven occlusive dissections and 11 stenotic dissections, including two each with a pseudoaneurysm) were followed up using both contrast-enhanced 3D MR angiography and cervical T1-weighted MR imaging at a median delay of 22 months. Ten patients underwent MR imaging at the acute phase as well, and nine underwent early follow-up angiography at a median delay of 3 months. MR angiographic findings were determined by consensus, focussing on image quality, presence of residual stenosis, luminal irregularities, and occlusion. RESULTS: Of the 32 VAs, a segment of the artery was not assessable on contrast-enhanced MR angiography in each of four small VAs. A central signal void artifact of cervical arteries was seen in one patient and motion artifacts were seen in two, but images could be interpreted. A venous enhancement was detected in 10 of 16 examinations, but this did not prevent image analysis. Ten of 11 stenotic dissections returned to normal, whereas one stenotic dissection progressed to occlusion. Two pseudoaneurysms detected by initial angiography resolved spontaneously; one was revealed only by delayed MR angiography, and one was detected on an early MR angiogram and proved resolved on a late MR angiogram. Of the seven initially occluded VAs, five reopened, with a hairline residual lumen in each of three. CONCLUSION: This preliminary experience showed that contrast-enhanced MR angiography is a promising tool for imaging VAs; it allows the assessment of VA dissection changes over time. Most lesions tended to heal spontaneously, but persisting occlusion or pseudoaneurysm could be detected during the late course.
Authors:
X Leclerc; C Lucas; O Godefroy; L Nicol; A Moretti; D Leys; J P Pruvo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  20     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-19     Completed Date:  1999-11-19     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1482-90     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, Hôpital Salengro, University Hospital of Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / diagnosis*,  therapy
Aneurysm, False / diagnosis
Artifacts
Contrast Media
Feasibility Studies
Female
Follow-Up Studies
Gadolinium DTPA / diagnostic use
Humans
Image Enhancement*
Image Processing, Computer-Assisted*
Intracranial Aneurysm / diagnosis*,  therapy
Magnetic Resonance Angiography*
Male
Middle Aged
Sensitivity and Specificity
Treatment Outcome
Vertebral Artery* / pathology
Vertebrobasilar Insufficiency / diagnosis*,  therapy
Chemical
Reg. No./Substance:
0/Contrast Media; 122795-43-1/gadodiamide; 80529-93-7/Gadolinium DTPA

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