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Visualization of the Intimal Flap in Intracranial Arterial Dissection Using High‐Resolution 3T MRI
Author(s) -
Uemura Masahiro,
Terajima Kenshi,
Suzuki Yuji,
Watanabe Masaki,
Akaiwa Yasuhisa,
Katada Shinichi,
Okamoto Kouichirou,
Nishizawa Masatoyo,
Igarashi Hironaka,
Nakada Tsutomu
Publication year - 2016
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12380
Subject(s) - medicine , radiology , magnetic resonance imaging , digital subtraction angiography , magnetic resonance angiography , icad , dissection (medical) , lumen (anatomy) , angiography , nuclear medicine , surgery , biochemistry , chemistry , gene
BACKGROUND AND PURPOSE Presence of an intimal flap is a critical imaging finding in diagnosing intracranial artery dissection (ICAD). Recent reports showed that high‐resolution magnetic resonance imaging (MRI) was better at identifying intimal flaps as compared with routine MRI techniques used in clinical settings. However, no current standardized sequence for high‐resolution MRI without gadolinium enhancement produces images of satisfactory quality with clinically tolerable scanning times. This study evaluated a nonenhanced high‐resolution fast spin echo (HR‐FSE) MRI sequence for visualizing intimal flaps in patients with ICAD. SUBJECTS AND METHODS Three patients with ICAD underwent plain MRI examination using a 2‐dimensional T2‐weighted FSE imaging sequence optimized for our 3T system (in‐plane pixel size, .23 mm × .23 mm; slice thickness 3 mm with no interslice gap), as well as scanning with conventional modalities, including CT angiography, magnetic resonance angiography, and digital subtraction angiography. We assessed whether these imaging methods could visualize an intimal flap and/or double lumen sign in the participants and compared the results between HR‐FSE and the other modalities. RESULTS HR‐FSE images clearly showed intimal flaps and double lumen signs in all 3 patients, whereas the conventional modalities identified a double lumen sign in only 2 of the 3 patients. CONCLUSIONS The present method of optimized HR‐FSE imaging with a 3T system improved visualization of intimal flaps and should thus be considered for assessing patients with suspected ICAD that cannot be definitively diagnosed by conventional imaging modalities.