PT  - JOURNAL ARTICLE
AU  - A.T. Vertinsky
AU  - N.E. Schwartz
AU  - N.J. Fischbein
AU  - J. Rosenberg
AU  - G.W. Albers
AU  - G. Zaharchuk
TI  - Comparison of Multidetector CT Angiography and MR Imaging of Cervical Artery Dissection
AID  - 10.3174/ajnr.A1189
DP  - 2008 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1753--1760
VI  - 29
IP  - 9
4099  - http://www.ajnr.org/content/29/9/1753.short
4100  - http://www.ajnr.org/content/29/9/1753.full
SO  - Am. J. Neuroradiol.2008 Oct 01; 29
AB  - BACKGROUND AND PURPOSE: Conventional angiography has been historically considered the gold standard for the diagnosis of cervical artery dissection, but MR imaging/MR angiography (MRA) and CT/CT angiography (CTA) are commonly used noninvasive alternatives. The goal of this study was to compare the ability of multidetector CT/CTA and MR imaging/MRA to detect common imaging findings of dissection.MATERIALS AND METHODS: Patients in the data base of our Stroke Center between 2003 and 2007 with dissections who had CT/CTA and MR imaging/MRA on initial work-up were reviewed retrospectively. Two neuroradiologists evaluated the images for associated findings of dissection, including acute ischemic stroke, luminal narrowing, vessel irregularity, wall thickening/hematoma, pseudoaneurysm, and intimal flap. The readers also subjectively rated each vessel on the basis of whether the imaging findings were more clearly displayed with CT/CTA or MR imaging/MRA or were equally apparent.RESULTS: Eighteen patients with 25 dissected vessels (15 internal carotid arteries [ICA] and 10 vertebral arteries [VA]) met the inclusion criteria. CT/CTA identified more intimal flaps, pseudoaneurysms, and high-grade stenoses than MR imaging/MRA. CT/CTA was preferred for diagnosis in 13 vessels (5 ICA, 8 VA), whereas MR imaging/MRA was preferred in 1 vessel (ICA). The 2 techniques were deemed equal in the remaining 11 vessels (9 ICA, 2 VA). A significant preference for CT/CTA was noted for VA dissections (P < .05), but not for ICA dissections.CONCLUSION: Multidetector CT/CTA visualized more features of cervical artery dissection than MR imaging/MRA. CT/CTA was subjectively favored for vertebral dissection, whereas there was no technique preference for ICA dissection. In many cases, MR imaging/MRA provided complementary or confirmatory information, particularly given its better depiction of ischemic complications.