MRI of intracranial vertebral artery dissection: evaluation of intramural haematoma using a black blood, variable-flip-angle 3D turbo spin-echo sequence

作者：Takano Koichi^*; Yamashita Shinnichi; Takemoto Koichiro; Inoue Tooru; Kuwabara Yasuo; Yoshimitsu Kengo

来源：Neuroradiology, 2013, 55(7): 845-851.

DOI：10.1007/s00234-013-1183-4

• Vertebral artery dissection
• Magnetic resonance imaging
• MR angiography
• Three dimensional
• Black blood

We investigated the efficacy of three-dimensional black blood T1-weighted imaging (3D-BB-T1WI) using a variable refocusing flip angle turbo spin-echo sequence in the diagnosis of intracranial vertebral artery dissection (VAD). %26lt;br%26gt;Sixteen consecutive patients diagnosed with intracranial VAD underwent magnetic resonance imaging that included 3D time-of-flight-MRA, axial spin-echo T1-weighted images (SE-T1WI) and oblique coronal 3D-BB-T1WI sequences. The visualization, morphology and extent of intramural haematomas were assessed and compared among the sequences. Results obtained by digital subtraction angiography (DSA), 3D-angiography and/or 3D-CT angiography (CTA) were used as standards of reference. %26lt;br%26gt;3D-BB-T1WI revealed intramural haematomas in all cases, whereas SE-T1WI and magnetic resonance angiography (MRA) failed to reveal a haematoma in one case and three cases, respectively. The mean visualization grading score for the intramural haematoma was the highest for 3D-BB-T1WI, and there was a statistically significant difference among the sequences (p %26lt; 0.001). At least a portion of the intramural haematoma was distinguishable from the lumen on 3D-BB-T1WI, whereas the haematomas were entirely indistinguishable from intraluminal signals on MRA in two cases (12.5 %) and on SE-T1WI in one case (6.3 %). 3D-BB-T1WI revealed the characteristic crescent shape of the intramural haematoma in 14 cases (87.5 %), whereas SE-T1WI and MRA revealed a crescent shape in only 7 cases (43.8 %) and 8 cases (50 %), respectively. In a consensus reading, 3D-BB-T1WI was considered the most consistent sequence in representing the extent and morphology of the lesion in 14 cases (87.5 %), compared to DSA and CTA. %26lt;br%26gt;3D-BB-T1WI is a promising method to evaluate intramural haematoma in patients with suspected intracranial VAD.

• 出版日期2013-7