Isabelle Nassenstein MD, Presenter: Nothing to Disclose

Rainald Bachmann MD, Abstract Co-Author: Nothing to Disclose

Stefan C. Kramer MD, Abstract Co-Author: Nothing to Disclose

Ralf Dittrich MD, Abstract Co-Author: Nothing to Disclose

Walter Leonhard Heindel MD, Abstract Co-Author: Nothing to Disclose

David Christian Maintz MD, Abstract Co-Author: Nothing to Disclose

Cervical artery dissection (CAD) is a dynamic disease with rapid changes over time. Aim of this prospective study was to assess the morphological changes within the first 6 months after disease onset.

83 patients with suspected CAD were examined using a 3.0 T system (Intera, Philips). The imaging protocol consisted of bright blood 3D TOF MRA (TR/TE/FA = 25ms/3.1ms/16°, reconstructed voxel size 0.3x0.3x0.8mm); black blood T1w 3D spoiled GE (TR/TE/FA = 31ms/7.7ms/15°, 0.3x0.3x1.0mm) before and after Gd application and fat suppressed T2w (TR/TE/ETL = 3 heart beats/44ms/7, 0.3x0.3x2mm). Short-term follow-up was performed after 15 days (mean), mid-term after 176 days (mean). Images were assessed with regard to the degree of stenosis, occlusion and recanalization, development of pseudoaneurysms and new dissections.

Initially, CAD was detected in 29 pts (= 33 vessels; 20 ICA, 13 VA). 29 vessels showed a stenosis, 4 were occluded. In 3 vessels a pseudoaneurysm was visible. 21 patients (= 24 vessels) were available for follow-up after 15 days. Degree of stenosis increased in 2 vessels, remained unchanged in 13 vessels and decreased in 5. All 4 occluded vessels showed spontaneous recanalization on follow up. In 3 vessels a new dissection occurred, in 1 vessel a new pseudoaneurysm was found. 15 pts (=19 vessels) were available for mid-term follow up after 176 days (mean).13 vessels showed complete recovery, 4 mild residual stenosis, 1 new pseudoaneurysm and 1 moderate stenosis and a new pseudoaneurysm. One patient developed a new dissection of 2 vessels.

High resolution MRI permitted an excellent analysis of the morphological features of CAD. Clinically important information can be gained with regard to the degree of recanalization, persistence of residual stenosis, development of pseudoaneurysm and incidence of new dissections.

Our study shows that CAD has a high rate of self-limitation and confirms the clinical practice to avoid early interventional recanalization procedures.

Nassenstein, I, Bachmann, R, Kramer, S, Dittrich, R, Heindel, W, Maintz, D, Short and Mid-term Follow-up in Patients with Proven Cervical Artery Dissection by High Resolution MRI at 3.0 T.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011323.html