3D fat-saturated T1 SPACE sequence for the diagnosis of cervical artery dissection.
BACKGROUND
This study aims to demonstrate the added value of a 3D fat-saturated (FS) T1 sampling perfection with application-optimised contrast using different flip angle evolutions (SPACE) sequence compared to 2D FS T1 spin echo (SE) for the diagnosis of cervical artery dissection.


METHODS
Thirty-one patients were prospectively evaluated on a 1.5-T MR system for a clinical suspicion of acute or subacute cervical artery dissection with 3D T1 SPACE sequence. In 23 cases, the axial 2D FS T1 SE sequence was also used; only these cases were subsequently analysed. Two neuroradiologists independently and blindly assessed the 2D and 3D T1 sequences. The presence of recent dissection (defined as a T1 hyperintensity in the vessel wall) and the quality of fat suppression were assessed. The final diagnosis was established in consensus, after reviewing all the imaging and clinical data.


RESULTS
Overall sensitivity and specificity were 0.929 and 1 for axial T1 SE, and 0.965 and 0.945 for T1 SPACE (P > 0.05), respectively. The two readers had excellent agreement for both sequences (k = 1 and 0.8175 for T1 SE and T1 SPACE, respectively; P > 0.05). The quality of the fat saturation was similar. Very good fat saturation was obtained in the upper neck. Multiplanar reconstructions were very useful in tortuous regions, such as the atlas loop of the vertebral artery or the carotid petrous entry. 3D T1 SPACE sequence has a shorter acquisition time (3 min 25 s versus 5 min 32 s for one T1 SE sequence) and a larger coverage area.


CONCLUSIONS
3D T1 SPACE sequence offers similar information with its 2D counterpart, in a shorter acquisition time and larger coverage area.
Department of Diagnostic and Interventional Neuroradiology, DISIM, University Hospitals of Geneva, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
Victor
V
Cuvinciuc
Magalie
M
Viallon
Isabelle
I
Momjian-Mayor
Roman
R
Sztajzel
Vitor Mendes
VM
Pereira
Karl-Olof
KO
Lovblad
Maria Isabel
MI
Vargas
D000273:Adipose Tissue / Q000473:pathology*; D000465:Algorithms; D020215:Carotid Artery, Internal, Dissection / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D020217:Vertebral Artery Dissection / Q000473:pathology*