title: Added value of high-resolution MR imaging in the diagnosis of vertebral artery dissection.
abstract: OBJECTIVE
  The optimal imaging method for the diagnosis of VAD remains undefined. Our aim was to evaluate the added value of HR-MR imaging for the diagnosis of VAD.
  
  
  METHODS
  We retrospectively extracted 35 consecutive patients suspected of having acute VAD who had the following: 1) a focal lumen abnormality of the VA on CE-MRA, 2) HR-MR imaging during the initial hospital stay, and 3) clinical and imaging follow-up within 6 months. Two neurologists classified patients as either VAD (group A) or non-VAD (group B) by reviewing all the available data at hospital discharge, except HR-MR imaging data. On HR-MR imaging, 2 radiologists searched for signs of acute VAD. The 2 classifications were compared. In case of discordance, CE-MRA follow-up and axial fat-suppressed T1WI, used to obtain supportive evidence for or against VAD, were considered as the standard of reference.
  
  
  RESULTS
  In 4/18 patients in group A, HR-MR imaging did not demonstrate any signs of acute VAD and perivertebral signal-intensity changes were attributed to venous plexus, with an unchanged lumen on follow-up. In 4/17 patients in group B, HR-MRI demonstrated a mural hematoma, with lumen normalization on follow-up CE-MRA.
  
  
  CONCLUSIONS
  Our results encourage the use of HR-MR imaging as a second-line diagnostic tool in the event of suspicion of acute VAD and doubtful findings on standard imaging.
authors.affiliation: Department of Neuroradiology, Paris-Descartes University, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, Paris, France. o.naggara@ch-sainte-anne.fr
authors.forename: O
authors.initials: O
authors.lastname: Naggara
authors.forename: F
authors.initials: F
authors.lastname: Louillet
authors.forename: E
authors.initials: E
authors.lastname: Touzé
authors.forename: D
authors.initials: D
authors.lastname: Roy
authors.forename: X
authors.initials: X
authors.lastname: Leclerc
authors.forename: J-L
authors.initials: JL
authors.lastname: Mas
authors.forename: J-P
authors.initials: JP
authors.lastname: Pruvo
authors.forename: J-F
authors.initials: JF
authors.lastname: Meder
authors.forename: C
authors.initials: C
authors.lastname: Oppenheim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020217:Vertebral Artery Dissection / Q000473:pathology*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine