A Dilated Surface Appearance on Basiparallel Anatomic Scanning-Magnetic Resonance Imaging Is a Useful Tool for the Diagnosis of Spontaneous Vertebral Artery Dissection in Lateral Medullary Infarction

作者：Itabashi Ryo^*; Mori Etsuro; Furui Eisuke; Sato Shoichiro; Yazawa Yukako; Kawata Kenta; Fujiwara Satoru

来源：Journal of Stroke and Cerebrovascular Diseases, 2014, 23(5): 805-810.

DOI：10.1016/j.jstrokecerebrovasdis.2013.07.003

• Acute stroke
• lateral medullary infarction
• vertebral artery
• dissection
• magnetic resonance imaging
• magnetic resonance angiography

Spontaneous dissection of the vertebral artery (VA) is a major vascular lesion causing lateral medullary infarction (LMI). A dilated surface appearance of the VA is a feature of VA dissection and can be observed on basiparallel anatomic scanning (BPAS)-magnetic resonance imaging (MRI). The aim of this study was to validate BPAS-MRI in the diagnosis of VA dissection in patients with LMI. The subjects of the present study were 41 consecutive patients with LMI within 7 days of onset. The diagnosis of VA dissection was made with the clinical criteria-based diagnosis. Percent (%) dilatation of the VA on BPAS-MRI was calculated by comparing the maximum surface diameter of the intracranial VA to the diameter of the distal normal surface of the VA. Fourteen patients (34%) were diagnosed with VA dissection. The optimal cutoff % dilatation of the VA for dissection was more than 169%. The sensitivity and specificity of % dilatation of VA more than 169% and aneurysmal dilatation, stenosis, or occlusion on magnetic resonance angiography (MRA) for VA dissection were 92.9% and 81.5%, respectively. BPAS-MRI combined with time-of-flight-MRA is a useful tool for the diagnosis of VA dissection in patients with acute LMI.

• 出版日期2014-6