European Radiology

, Volume 19, Issue 9, pp 2255–2260 | Cite as

High-resolution MR imaging of periarterial edema associated with biological inflammation in spontaneous carotid dissection

  • Olivier Naggara
  • Emmanuel Touzé
  • Rodolpho Marsico
  • Xavier Leclerc
  • Thanh Nguyen
  • Jean-Louis Mas
  • Jean-Pierre Pruvo
  • Jean-François Meder
  • Catherine Oppenheim


It has been suggested that spontaneous cervical carotid artery dissection (sCAD) may result from arterial inflammation. Periarterial edema (PAE), occasionally described in the vicinity of the mural hematoma in patients with sCAD, may support this hypothesis. Using cervical high-resolution magnetic resonance imaging, three readers, blinded to the mechanism of carotid artery dissection, searched for PAE, defined as periarterial T2-hyperintensity and T1-hypointensity, in 29 consecutive CAD patients categorized as spontaneous CAD (sCAD, n = 18) or traumatic CAD (tCAD, n = 11; i.e., major head or neck trauma within 2 weeks before the clinical onset). The relationships between PAE, inflammatory biological markers, history of infection and CAD mechanism were explored. Multiple CADs (n = 8) were found only in sCAD patients. Compared with tCAD, patients with sCAD were more likely to have a recent history of infection (OR = 12.5 [95%CI = 1.3–119], p = 0.03), PAE (83% vs. 27%; OR = 13.3 [95%CI = 2.2–82.0], p = 0.005) and to have elevated CRP (OR = 6.1 [95%CI = 1.2–32.1], p = 0.0002) or ESR (OR = 8.8 [95%CI = 1.5–50.1], p = 0.002) values. Interobserver agreement was 0.84 or higher for PAE identification. sCAD was associated with PAE and biological inflammation. Our results support the hypothesis of an underlying arterial inflammation in sCAD.


Magnetic resonance imaging (MRI) Cervical artery dissection Carotid disease Inflammation 


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Olivier Naggara
    • 1
  • Emmanuel Touzé
    • 2
  • Rodolpho Marsico
    • 1
  • Xavier Leclerc
    • 3
  • Thanh Nguyen
    • 4
  • Jean-Louis Mas
    • 2
  • Jean-Pierre Pruvo
    • 3
  • Jean-François Meder
    • 1
  • Catherine Oppenheim
    • 1
  1. 1.Department of NeuroradiologyParis-Descartes UniversityParisFrance
  2. 2.Department of NeurologyParis-Descartes UniversityParisFrance
  3. 3.Department of NeuroradiologyUniversity Hospital Roger SalengroLilleFrance
  4. 4.Department of Neurology, Neurosurgery, and RadiologyBoston University Medical CenterBostonUSA

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