title: A dilated surface appearance on basiparallel anatomic scanning-magnetic resonance imaging is a useful tool for the diagnosis of spontaneous vertebral artery dissection in lateral medullary infarction.
abstract: Spontaneous dissection of the vertebral artery (VA) is a major vascular lesion causing lateral medullary infarction (LMI). A dilated surface appearance of the VA is a feature of VA dissection and can be observed on basiparallel anatomic scanning (BPAS)-magnetic resonance imaging (MRI). The aim of this study was to validate BPAS-MRI in the diagnosis of VA dissection in patients with LMI. The subjects of the present study were 41 consecutive patients with LMI within 7 days of onset. The diagnosis of VA dissection was made with the clinical criteria-based diagnosis. Percent (%) dilatation of the VA on BPAS-MRI was calculated by comparing the maximum surface diameter of the intracranial VA to the diameter of the distal normal surface of the VA. Fourteen patients (34%) were diagnosed with VA dissection. The optimal cutoff % dilatation of the VA for dissection was more than 169%. The sensitivity and specificity of % dilatation of VA more than 169% and aneurysmal dilatation, stenosis, or occlusion on magnetic resonance angiography (MRA) for VA dissection were 92.9% and 81.5%, respectively. BPAS-MRI combined with time-of-flight-MRA is a useful tool for the diagnosis of VA dissection in patients with acute LMI.
authors: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan; Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. Electronic address: ritabash@kohnan-sendai.or.jp.
authors: Ryo
authors: R
authors: Itabashi
authors: Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors: Etsuro
authors: E
authors: Mori
authors: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan.
authors: Eisuke
authors: E
authors: Furui
authors: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan.
authors: Shoichiro
authors: S
authors: Sato
authors: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan.
authors: Yukako
authors: Y
authors: Yazawa
authors: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan.
authors: Kenta
authors: K
authors: Kawata
authors: Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
authors: Satoru
authors: S
authors: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D015203:Reproducibility of Results; D014711:Vertebral Artery / Q000473:pathology*; D020217:Vertebral Artery Dissection / Q000175:diagnosis* / Q000473:pathology
keywords: Acute stroke; dissection; lateral medullary infarction; magnetic resonance angiography; magnetic resonance imaging; vertebral artery