Internal carotid artery dissection: MR imaging features and clinical-radiologic correlation.
OBJECTIVE
To analyze the usefulness of magnetic resonance (MR) imaging techniques and diagnostic sensitivity in internal and carotid artery dissection (ICAD) and to correlate these findings with those of other imaging modalities and with clinical signs.


METHODS
Thirty-one patients with ICAD underwent MR imaging within 2-40 days (mean, 13 days) after onset of clinical symptoms. All patients initially underwent Doppler sonography; 15 patients underwent additional angiographic studies.


RESULTS
T1-weighted fat-suppressed MR images most accurately demonstrated intramural hematoma in the internal carotid artery (ICA) in all patients. Kinking or coiling of the ICA was found in nine (29%) patients. Hyperintense signal was seen on T1- and T2-weighted images in the carotid canal or in the cavernous sinus in two-thirds of the patients. Findings characteristic of ICAD were seen on 13 of 16 angiograms.


CONCLUSIONS
MR imaging most accurately demonstrated ICAD. The high rate of kinking and coiling in the carotid artery suggests that these anatomic conditions may be predisposing factors.
Ozdoba
C
C
Department of Neuroradiology, University of Bern, Inselspital, Switzerland.
Sturzenegger
M
M
Schroth
G
G
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis*; D002340:Carotid Artery Diseases / Q000175:diagnosis*; D002343:Carotid Artery, Internal / Q000473:pathology; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity