Miran Han MD, Presenter: Nothing to Disclose

Jin Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Young Keun Sur MD, Abstract Co-Author: Nothing to Disclose

Seon Young Park MD, Abstract Co-Author: Nothing to Disclose

Sun Yong Kim MD, Abstract Co-Author: Nothing to Disclose

To evaluate the feasibility of HR-MR imaging to diagnose intracranial vertebrobasilar artery dissection (VBD) and to find most useful imaging findings suggesting dissection  

We retrospectively reviewed 55 patients suspected of having intracranial VBDs and underwent HR-MR imaging between March 2012 and October 2013. Two neuroradiologists independently reviewed the HR-MR images. The diagnosis based on only HR-MR imaging was compared with final diagnosis by the consensus among neuroradiologists, neurointerventionist and neurologist after reviewing all clinical and paraclinical investigations available at hospital discharge (initial CT, MR, DSA images and etiologic work-ups) and follow up. Two neuroradiologists also looked for indications of dissection (mural hematoma, dissection flap, outer diameter enlargement on T2WI of steno-occlusive lesion on angiography) on each sequence of HR-MRI. Interobserver agreement for diagnosing the VBD and inter- and intraobserver agreement for detecting evidence of dissection were estimated using the Cohen’s kappa coefficient  

5 patients were excluded because scanning range of HR-MR imaging did not fully cover the affected segment. Among the 50 study population, 33 patients were finally diagnosed with VBD by consensus of various specialists. Diagnosis based on HR-MR imaging corroborated the final diagnosis in 47 (94%, 31 VBD and 16 No VBD) patients. A mural hematoma was best detected on T1WI and CE-T1WI (54.3%). Dissection flaps were seen in almost all cases on CE-T1WI (91.4%) and secondly detected on T2WI (68.6%). Outer-diameter enlargement of the steno-occlusive lesions on angiography was detected in more than half of cases (62.86%). The two reviewers showed substantial to almost perfect agreement for diagnosis of VBD and detecting dissection signs on every sequence.  

HR-MR imaging could be a useful and non-invasive diagnostic tool for intracranial VBDs and dissection flap on CE-T1WI is most confident sign for suggesting dissection  

HR-MR imaging can demonstrate direct findings of dissection and be non-invasive useful diagnostic tool for the diagnosis of intracranial vertebrobasilar artery dissection  

Han, M, Choi, J, Sur, Y, Park, S, Kim, S, Feasibility of High-resolution MR Imaging for the Diagnosis of Intracranial Vertebrobasilar Artery Dissection.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017548.html