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AJNR - American Journal of Neuroradiology

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Surface Appearance of the Vertebrobasilar Artery Revealed on Basiparallel Anatomic Scanning (BPAS)–MR Imaging: Its Role for Brain MR Examination

Morio Nagahata^a, Yoshinao Abe^b, Shuichi Ono^b, Takaaki Hosoya^c and Seiyu Uno^a

^a Department of Radiology, Kuroishi City Hospital, Kuroishi-shi, Japan
^b Department of Radiology, Hirosaki University School of Medicine, Hirosaki-shi, Japan
^c Department of Radiology, Yamagata University School of Medicine, Yamagata-shi, Japan

View larger version (115K): [in a new window]   FIG 1. A midsagittal scout view (A) shows the location of a BPAS scan. White box indicates a thick coronal section posteriorly parallel to the clivus. BPAS-MR imaging (B) demonstrates an overview of the vertebrobasilar artery within the cistern.

View larger version (117K): [in a new window]   FIG 2. A typical case of "atherosclerosis." MRA (A) reveals irregular defects within the basilar trunk (arrows). Its outer contour on BPAS-MR imaging (B) is relatively smooth, not stenotic.

View larger version (128K): [in a new window]   FIG 3. A typical case of unilateral VA "occlusive condition." Although the right VA is very narrow and not visualized clearly on MRA (A, arrows), its sufficient outer caliber is confirmed on BPAS-MR imaging (B, arrows). T2-weighted image (C) shows absence of normal "flow void" in the right VA (arrows) that suggests the arterial occlusion. A source image of 3D TOF MRA (D) and a reformatted thick coronal image (E) hardly show the outer diameter of the occluded right VA (D and E, arrows)

View larger version (68K): [in a new window]   FIG 4. A case of unilateral hypoplastic VA, classified as "hypoplastic VA." The right VA is not seen clearly on MRA (A, arrows). A small and hypoplastic right VA is confirmed on BPAS-MR imaging (B, arrows). T2-weighted image (C) shows no vascular structure suggesting the right VA.

View larger version (74K): [in a new window]   FIG 5. Another case of "hypoplastic VA." The right VA terminates in the posterior inferior cerebellar artery (PICA) on both MRA (A, arrows) and BPAS-MR imaging (B, arrows). Note the absence of the distal right VA on BPAS-MR imaging (B). On T2-weighted axial image (C), it is actually difficult to distinguish from the right PICA from the hypoplastic small VA.

View larger version (135K): [in a new window]   FIG 6. A case of right VA aneurysm. The right VA aneurysm on MRA (A) is not clear. Its shape is not equal to what is evident on BPAS-MR imaging (B), perhaps due to partial thrombosis and/or turbulent flow within the aneurysm.