PT - JOURNAL ARTICLE AU - O. Naggara AU - F. Louillet AU - E. TouzĂ© AU - D. Roy AU - X. Leclerc AU - J.-L. Mas AU - J.-P. Pruvo AU - J.-F. Meder AU - C. Oppenheim TI - Added Value of High-Resolution MR Imaging in the Diagnosis of Vertebral Artery Dissection AID - 10.3174/ajnr.A2165 DP - 2010 Oct 01 TA - American Journal of Neuroradiology PG - 1707--1712 VI - 31 IP - 9 4099 - http://www.ajnr.org/content/31/9/1707.short 4100 - http://www.ajnr.org/content/31/9/1707.full SO - Am. J. Neuroradiol.2010 Oct 01; 31 AB - BACKROUND AND PURPOSE: The optimal imaging method for the diagnosis of VAD remains undefined. Our aim was to evaluate the added value of HR-MR imaging for the diagnosis of VAD. MATERIALS AND METHODS: We retrospectively extracted 35 consecutive patients suspected of having acute VAD who had the following: 1) a focal lumen abnormality of the VA on CE-MRA, 2) HR-MR imaging during the initial hospital stay, and 3) clinical and imaging follow-up within 6 months. Two neurologists classified patients as either VAD (group A) or non-VAD (group B) by reviewing all the available data at hospital discharge, except HR-MR imaging data. On HR-MR imaging, 2 radiologists searched for signs of acute VAD. The 2 classifications were compared. In case of discordance, CE-MRA follow-up and axial fat-suppressed T1WI, used to obtain supportive evidence for or against VAD, were considered as the standard of reference. RESULTS: In 4/18 patients in group A, HR-MR imaging did not demonstrate any signs of acute VAD and perivertebral signal-intensity changes were attributed to venous plexus, with an unchanged lumen on follow-up. In 4/17 patients in group B, HR-MRI demonstrated a mural hematoma, with lumen normalization on follow-up CE-MRA. CONCLUSIONS: Our results encourage the use of HR-MR imaging as a second-line diagnostic tool in the event of suspicion of acute VAD and doubtful findings on standard imaging. CE-MRAcontrast-enhanced MR angiographyCIconfidence intervalDSAdigital subtraction angiographyDUSDoppler ultrasonography examinationDWIdiffusion-weighted imagingHRhigh resolutionNIHSSNational Institutes of Health Stroke ScalePDWIproton attenuation− weighted imagingT1WIT1-weighted imagingT2WIT2-weighted imagingTEeffeffective echo-timeTOFtime of flightV2 and V3the second and third VA segmentsVAvertebral arteryVADVA dissection