[MRI with fat suppression in the visualization of wall hematoma in spontaneous dissection of the internal carotid artery].
OBJECTIVE
Comparison of different MR-examination techniques for the diagnosis of acute spontaneous internal carotid artery dissection.


METHODS
13 patients (age range 23-59 years) with symptomatic spontaneous dissection of the internal carotid artery were examined. The MRI protocol contained a transverse spin echo sequence, a time-of-flight MR-angiography and a coronal fat suppressed T1-weighted sequence. The earliest examination was performed three days after symptom onset. Follow-up extended up to 30 months. We compared the three different sequences to find out the one that demonstrated the hematoma best.


RESULTS
MR-angiography shows a narrowing of the vessel diameter in early examinations. During the subacute stage methemoglobin can obscure this finding. From the third day on fat suppressed T1-weighted images showed a hyperintense hematoma that strongly contrasted to the surrounding fatty tissue. Fat suppressed images showed a hyperintense hematoma up to 10 months after symptom onset while MRA and spin echo sequences did not.


CONCLUSIONS
Fat suppressed T1-weighted images are superior in showing vessel wall hematoma and should thus be used in the standard MR-protocol for spontaneous internal carotid artery dissection.
Fiebach
J
J
Abteilung Neuroradiologie, Neurologischen Klinik, Universitätsklinikum Heidelberg. jochen_fiebach@med.uni-heidelberg.de
Brandt
T
T
Knauth
M
M
Jansen
O
O
D000273:Adipose Tissue; D000328:Adult; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis*; D005260:Female; D006406:Hematoma / Q000175:diagnosis*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
MRT mit Fettsuppression zur Darstellung des Wandhämatoms bei spontaner Dissektion der A. carotis interna.