title: Comparison of multidetector CT angiography and MR imaging of cervical artery dissection.
abstract: OBJECTIVE
  Conventional angiography has been historically considered the gold standard for the diagnosis of cervical artery dissection, but MR imaging/MR angiography (MRA) and CT/CT angiography (CTA) are commonly used noninvasive alternatives. The goal of this study was to compare the ability of multidetector CT/CTA and MR imaging/MRA to detect common imaging findings of dissection.
  
  
  METHODS
  Patients in the data base of our Stroke Center between 2003 and 2007 with dissections who had CT/CTA and MR imaging/MRA on initial work-up were reviewed retrospectively. Two neuroradiologists evaluated the images for associated findings of dissection, including acute ischemic stroke, luminal narrowing, vessel irregularity, wall thickening/hematoma, pseudoaneurysm, and intimal flap. The readers also subjectively rated each vessel on the basis of whether the imaging findings were more clearly displayed with CT/CTA or MR imaging/MRA or were equally apparent.
  
  
  RESULTS
  Eighteen patients with 25 dissected vessels (15 internal carotid arteries [ICA] and 10 vertebral arteries [VA]) met the inclusion criteria. CT/CTA identified more intimal flaps, pseudoaneurysms, and high-grade stenoses than MR imaging/MRA. CT/CTA was preferred for diagnosis in 13 vessels (5 ICA, 8 VA), whereas MR imaging/MRA was preferred in 1 vessel (ICA). The 2 techniques were deemed equal in the remaining 11 vessels (9 ICA, 2 VA). A significant preference for CT/CTA was noted for VA dissections (P < .05), but not for ICA dissections.
  
  
  CONCLUSIONS
  Multidetector CT/CTA visualized more features of cervical artery dissection than MR imaging/MRA. CT/CTA was subjectively favored for vertebral dissection, whereas there was no technique preference for ICA dissection. In many cases, MR imaging/MRA provided complementary or confirmatory information, particularly given its better depiction of ischemic complications.
authors.affiliation: Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: A T
authors.initials: AT
authors.lastname: Vertinsky
authors.forename: N E
authors.initials: NE
authors.lastname: Schwartz
authors.forename: N J
authors.initials: NJ
authors.lastname: Fischbein
authors.forename: J
authors.initials: J
authors.lastname: Rosenberg
authors.forename: G W
authors.initials: GW
authors.lastname: Albers
authors.forename: G
authors.initials: G
authors.lastname: Zaharchuk
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis; D000792:Angiography; D002343:Carotid Artery, Internal / Q000473:pathology; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis*; D002544:Cerebral Infarction / Q000175:diagnosis; D054893:Cone-Beam Computed Tomography; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000473:pathology; D020217:Vertebral Artery Dissection / Q000175:diagnosis*
chemical_list: D003287:Contrast Media