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Spontaneous and Unruptured Chronic Intracranial Artery Dissection

High-resolution Magnetic Resonance Imaging Findings

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Abstract

Purpose

The aim of this article is to present high-resolution magnetic resonance imaging (HR-MRI) findings of chronic stage spontaneous and unruptured intracranial artery dissection (ICAD).

Material and Methods

From March 2012 to April 2016 a total of 29 patients (15 male and14 female, age range 37–68 years) with chronic stage spontaneous and unruptured ICAD (vertebral artery 27, posterior inferior cerebellar artery 1 and middle cerebral artery 1) were retrospectively enrolled. Patients underwent HR-MRI more than 2 months (median interval 564 days, range 69–391 days) after symptom onset and were diagnosed at symptom onset or at the first imaging acquisition, which included luminal angiography and/or HR-MRI with clinical information. The HR-MRI findings were evaluated against those of luminal angiography on the basis of the lumen wall morphology, including thickening, contrast enhancement and residual dissection.

Results

The HR-MRI findings were classified into complete normalization (normal lumen and wall with or without mild enhancement, n = 6), complete normalization with minimal wall changes (focal wall thickening with enhancement but normal luminal angiography, n = 8), incomplete normalization (focal wall thickening with enhancement with dilatation and stenosis on luminal angiography, n = 4), dissecting aneurysm (fusiform aneurysm with residual dissection findings, n = 8) and occlusion (small outer arterial diameter with diffuse contrast enhancement, n = 3).

Conclusion

The use of HR-MRI can demonstrate the distinguishing morphological features of chronic stage of spontaneous and unruptured ICAD as complete normalization, complete normalization with minimal wall changes, incomplete normalization, dissecting aneurysm and occlusion.

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Acknowledgements

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (HI12C1847). The authors gratefully acknowledge technical support from Biomedical Imaging Infrastructure, Department of Radiology, Asan Medical Center.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, 138–736, Seoul, Songpa-Gu, Republic of Korea

    Seung Chai Jung, Ho Sung Kim, Choong-Gon Choi & Sang Joon Kim

  2. Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

    Sun U. Kwon, Dong-Wha Kang & Jong S. Kim

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  1. Seung Chai Jung
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  2. Ho Sung Kim
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  3. Choong-Gon Choi
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  4. Sang Joon Kim
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  7. Jong S. Kim
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Correspondence to Seung Chai Jung.

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Conflict of Interests

S.C. Jung, H.S. Kim, C.-G. Choi, S.J. Kim, S.U. Kwon, D.-W. Kang and J.S. Kim declare that they have no competing interests. This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (HI12C1847).

This retrospective study was approved by our institutional review board and informed consent was waived. Patient information was anonymized and de-identified before making the assessments.

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Jung, S.C., Kim, H.S., Choi, CG. et al. Spontaneous and Unruptured Chronic Intracranial Artery Dissection. Clin Neuroradiol 28, 171–181 (2018). https://doi.org/10.1007/s00062-016-0544-x

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  • DOI: https://doi.org/10.1007/s00062-016-0544-x

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