Keita Sakurai MD, Presenter: Nothing to Disclose

Susumu Kobayashi, Abstract Co-Author: Nothing to Disclose

Takatsune Kawaguchi MD, Abstract Co-Author: Nothing to Disclose

Motoo Nakagawa MD, Abstract Co-Author: Nothing to Disclose

Yuta Shibamoto MD, PhD, Abstract Co-Author: Nothing to Disclose

Although various sequences of magnetic resonance imaging including T1-weighted imaging (T1WI), magnetic resonance angiography and contrast-enhanced three-dimensional (CE3D) imaging with spoiled gradient-recalled acquisition in the steady state (SPGR) have been reported to be useful in the evaluation of vertebrobasilar artery dissections (VAD), no study has used 3D variable refocusing flip angle turbo spin echo (Volume ISotropic TSE Acquisition; VISTA) imaging, to our knowledge. VISTA imaging can decrease flow artifacts by sequence-endogenous flow-void enhancement. The aim of this study was to evaluate the ability of VISTA imaging in detecting vessel lumen and wall abnormalities in VAD.

Presence of an intramural hematoma, intimal flap, dilatation of the lumen and abnormal vessel enhancement was evaluated on T1VISTA imaging in 13 VAD patients. Ten of the 13 patients underwent an additional gadolinium-enhanced study. In addition to T1VISTA imaging, CE3D-SPGR imaging and electrocardiographically–gated black blood (BB) T1WI were performed to compare the conspicuity of intimal flaps in ten and eight of the patients, respectively.

An intramural hematoma, intimal flap and dilatation of the lumen were identified in 46% (6/13), 77% (10/13) and 92% (12/13) of the VAD patients, respectively, on T1VISTA imaging. Abnormal vessel enhancement was recognized in 100% (10/10) of the VAD patients on contrast-enhanced T1VISTA imaging. Compared with T1VISTA, CE3D-SPGR imaging tended to overlook intimal flaps; 60% (6/10) of the intimal flaps, especially in four cases with aneurysmal-type dissections without hematomas, were overlooked. As well as BBT1WI, T1VISTA could reveal intimal flaps and intramural hematomas.

T1VISTA imaging might be useful for diagnosing VAD by depicting thin intimal flaps of the false lumen without hematoma.

T1VISTA imaging can depict thin intimal flaps especially in cases with aneurismal-type VAD without intramural hematomas. This sequence might play an important role in the non-invasive assessment of VA

Sakurai, K, Kobayashi, S, Kawaguchi, T, Nakagawa, M, Shibamoto, Y, Utility of the Volume Isotropic Turbo Spin-Echo Acquisition Sequence in Diagnosing Vertebrobasilar Dissections: A Preliminary Study  .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11011262.html