AJDRAJNR - American Journal of Neuroradiology

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Leclerc, X.
Right arrow Articles by Pruvo, J. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Leclerc, X.
Right arrow Articles by Pruvo, J. P.

Preliminary Experience Using Contrast-Enhanced MR Angiography to Assess Vertebral Artery Structure for the Follow-up of Suspected Dissection

Xavier LeclercGo,a, Christian Lucasa, Olivier Godefroya, Lionel Nicola, Aline Morettia, Didier Leysa and Jean Pierre Pruvoa

a From the Departments of Neuroradiology (X.L., A.M., J.P.P.) and Neurology (C.L., O.G., D.L.), Hôpital Salengro, University Hospital of Lille, Lille, and the Medical Division (L.N.), Siemens, Saint-Denis, France.



View larger version (160K):

[in a new window]
  		FIG 1. A 48-year-old man with occipital headaches, neck pain, and Wallenberg's syndrome.

A, Selective angiogram of the left VA shows typical aspect of stenotic dissection with a long stenosis (arrows) involving the V3 and V4 segments of the VA.

B, Early follow-up conventional angiogram, obtained at 4 months, shows a normal left VA (arrow) with complete resolution of luminal abnormalities.

C, Contrast-enhanced MR angiogram, obtained 29 months later, shows normal appearance of the left VA (arrow).



View larger version (112K):

[in a new window]
  		FIG 2. A 37-year-old man with neck pains and vertigo after minor cervical trauma.

A, T1-weighted axial MR image (obtained 1 day after B) at the C3-C4 level, shows a typical aspect of dissection of the right VA, including a crescentic high signal (arrow) of the mural hematoma surrounding a narrowed signal void (arrowhead) of the residual lumen.

B, Arch aortogram with oblique view. The left VA appears normal (arrow), whereas the right VA is not visible, suggesting its complete occlusion. A selective angiogram of the right subclavian artery confirmed the diagnosis of VA occlusion.

C, Oblique view selective angiogram of the right VA, obtained at 3 months, shows recanalization of the artery (arrow) without residual luminal irregularities.

D, Contrast-enhanced MR angiogram, obtained at 8 months, with selective subvolume MIP reconstruction of VAs, shows a normal appearance of the right VA (arrow), consistent with findings revealed by conventional angiography.



View larger version (224K):

[in a new window]
  		FIG 3. A 45 year-old-woman with severe headaches.

A, Oblique-view selective conventional angiogram of the left VA shows aneurysmal-type dissection, with a 3-mm-diameter pseudoaneurysm (arrow) involving the V3 segment of the artery.

B, Oblique view MR angiogram shows good analysis of the entire length of the left VA (arrows), with resolution of the pseudoaneurysm.



View larger version (189K):

[in a new window]
  		FIG 4. A 39-year-old man with neck pain and Wallenberg's syndrome.

A, Arch aortogram shows a small left VA (arrow), whereas the right VA is not visible.

B, Contrast-enhanced MR angiogram, obtained at 2 months, shows complete recanalization of the right VA, with a fusiform pseudoaneurysm in its intradural segment (arrow).

C, Contrast-enhanced MR angiogram, obtained at 6 months, shows a normal aspect of the right VA (arrow), with a complete resolution of the pseudoaneurysm.

D, T1-weighted MR image, obtained at 9 days, shows a typical aspect of dissection of the intradural segment of the right VA with a crescentic high signal (arrow) surrounding a narrowed signal void (arrowhead).

E, T1-weighted axial MR image, obtained at 6 months, shows a spontaneous resolution of the mural hematoma of the right VA (arrow).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X