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Imaging investigation of intracranial arterial dissecting aneurysms by using 3 T high-resolution MRI and DSA: from the interventional neuroradiologists’ view

  • Clinical Article - Vascular
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Abstract

Objectives

The purpose of this study was to investigate vessel wall imaging features combined with the luminal shapes of intracranial dissecting aneurysms (IDAs) by using 3 Tesla (3T) high-resolution magnetic resonance imaging (MRI) and digital subtraction angiography (DSA).

Methods

Sixty-seven patients with 76 IDAs were consecutively enrolled in the study from December 2011 to May 2013. DSA was performed to diagnose an IDA and to categorize its angiography patterns into either aneurysmal dilation, steno-occlusive, combined, or unclassifiable. Images of 3T high-resolution MRI were used to evaluate arterial wall imaging features of each lesion. Chi-squared tests were used for statistical analyses.

Results

Aneurysmal dilation (51 of 76, [67 %]) was the most common angiography pattern of IDAs, followed by the combined pattern (20 of 76, [26 %]). Seven percent (five of 76) of IDAs showed steno-occlusive (n = 3) and unclassifiable (n = 2) angiography patterns, in which intramural hematomas were detected in the arterial wall without luminal connection. Intimal flaps (32 of 76, [42 %]), double-lumen sign (38 of 76, [50 %]) and intramural hematomas (46 of 76, [61 %]) were recognized as the characteristic features of dissection by high-resolution MRI. Intramural hematomas occurred more frequently in the combined patterns group (16 of 20, [80 %]) than in the aneurysmal dilation group (25 of 51, [49 %]) (P = .017), while the occurrence of intimal flaps and double-lumen sign did not differ between angiographic patterns (P > .05).

Conclusions

3T high-resolution MRI combined with DSA offered clear visualization of vessel wall features and accurate assessment of the vessel lumen in IDAs. This combined approach would be highly useful for understanding the underlying pathological status of IDAs and in guiding treatment choices.

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Acknowledgments

The authors thank Dr. Bin Jiang, M.D., and Liqing Yang, M.S., from the Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China, for helping with statistics consultation and analysis. The authors also thank Kristin Hood, Ph.D., Covidien, Bedford, MA USA, for providing English-language editing of this article.

Role of the funding source

Natural Science Foundation of China (grant nos. 81220108007, 81171079, and 81101034), National ‘Twelfth Five-Year’ Plan for Science & Technology Support (grant no. 2011BAI08B06), High-Level Health Technique Talent Training Plan of Beijing Health System (grant no. 2009-3-22), Beijing Nova Program (grant no. 2009B30).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China

    Yanmin Wang, Youxiang Li, Chuanhui Li, Peng Jiang & Xinjian Yang

  2. Department of Radiology, People’s Liberation Army (PLA) General Hospital, Beijing, China

    Xin Lou

  3. Department of Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Binbin Sui & Shengjun Sun

  4. Department of Neurosurgery and Radiology and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA

    Adnan Siddiqui

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  1. Yanmin Wang
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Correspondence to Xinjian Yang.

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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 156, 515–525 (2014). https://doi.org/10.1007/s00701-013-1989-1

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  • DOI: https://doi.org/10.1007/s00701-013-1989-1

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