title: Age determination of vessel wall hematoma in spontaneous cervical artery dissection: a multi-sequence 3T cardiovascular magnetic resonance study.
abstract: BACKGROUND
  Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR) in determining the age of vessel wall hematoma (VWH) in patients with spontaneous cervical artery dissection (sCAD).
  
  
  METHODS
  35 consecutive patients (mean age 43.6 ± 9.8 years) with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome) and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images.
  
  
  RESULTS
  The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p < 0.001 for trend). Agreement was moderate between VWH types in our study and the previously proposed time scheme of signal evolution for cerebral hemorrhage, Cohen's kappa 0.43 (p < 0.001). There was a strong agreement of CMR VWH classification compared to the time scheme which was proposed for carotid intraplaque hematomas with Cohen's kappa of 0.74 (p < 0.001).
  
  
  CONCLUSIONS
  Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.
authors: Dept, of Clinical Radiology, University of Munich, Grosshadern Campus, Munich, Germany.
authors: Maximilian
authors: M
authors: Habs
authors: Thomas
authors: T
authors: Pfefferkorn
authors: Clemens C
authors: CC
authors: Cyran
authors: Jochen
authors: J
authors: Grimm
authors: Axel
authors: A
authors: Rominger
authors: Marcus
authors: M
authors: Hacker
authors: Christian
authors: C
authors: Opherk
authors: Maximilian F
authors: MF
authors: Reiser
authors: Konstantin
authors: K
authors: Nikolaou
authors: Tobias
authors: T
authors: Saam
mesh_terms: D000328:Adult; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005858:Germany; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D002546:Ischemic Attack, Transient / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D020217:Vertebral Artery Dissection / Q000150:complications / Q000175:diagnosis* / Q000473:pathology