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October 12, 2015: Noninvasive imaging of arterial dissection with MRI

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Brought to you by the Residents & Fellows Section of Neurology.

October 12, 2015

Noninvasive imaging of arterial dissection with MRI

Digital subtraction angiography (DSA) has been the gold standard for the diagnosis of arterial dissection. High-resolution MRI (HR-MRI) is an imaging modality that incorporates fat- and blood-suppressed T2 and T1 acquisition sequences to a standard brain MRI protocol1. Whereas DSA and CT angiography can visualize the shape of a vessel lumen, HR-MRI can evaluate the vessel lumen and arterial wall structure. Thus, HR-MRI can aid in the diagnosis of arterial dissection and inform underlying pathophysiology by identification of a double lumen, intimal flap, and intramural hematoma. Comparisons of HR-MRI with DSA have validated its efficacy in evaluating both intracranial and extra cranial dissections of the anterior and posterior cerebral circulations1, 2.

  1. Wang Y, Lou X, Li Y, et al. Imaging investigation of intracranial arterial dissecting aneurysms by using 3 T high-resolution MRI and DSA: from the interventional neuroradiologists' view. Acta Neurochir 2014; 156: 515-525.
  2. Han M, Rim N, Lee J, Kim SY, Choi JW. Feasibility of high-resolution MR imaging for the diagnosis of intracranial vertebrobasilar artery dissection. Eur Radiol 2014; 24: 3017-3024.

Submitted by Adam Numis, MD, Department of Neurology, University of California, Los Angeles.

Disclosures: Dr. Numis is a member of the Resident and Fellow Section of Neurology.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology. Listen to this week's Neurology Podcast.

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