title: Imaging investigation of intracranial arterial dissecting aneurysms by using 3 T high-resolution MRI and DSA: from the interventional neuroradiologists' view.
abstract: OBJECTIVE
  The purpose of this study was to investigate vessel wall imaging features combined with the luminal shapes of intracranial dissecting aneurysms (IDAs) by using 3 Tesla (3T) high-resolution magnetic resonance imaging (MRI) and digital subtraction angiography (DSA).
  
  
  METHODS
  Sixty-seven patients with 76 IDAs were consecutively enrolled in the study from December 2011 to May 2013. DSA was performed to diagnose an IDA and to categorize its angiography patterns into either aneurysmal dilation, steno-occlusive, combined, or unclassifiable. Images of 3T high-resolution MRI were used to evaluate arterial wall imaging features of each lesion. Chi-squared tests were used for statistical analyses.
  
  
  RESULTS
  Aneurysmal dilation (51 of 76, [67%]) was the most common angiography pattern of IDAs, followed by the combined pattern (20 of 76, [26%]). Seven percent (five of 76) of IDAs showed steno-occlusive (n = 3) and unclassifiable (n = 2) angiography patterns, in which intramural hematomas were detected in the arterial wall without luminal connection. Intimal flaps (32 of 76, [42%]), double-lumen sign (38 of 76, [50%]) and intramural hematomas (46 of 76, [61%]) were recognized as the characteristic features of dissection by high-resolution MRI. Intramural hematomas occurred more frequently in the combined patterns group (16 of 20, [80 %]) than in the aneurysmal dilation group (25 of 51, [49%]) (P = .017), while the occurrence of intimal flaps and double-lumen sign did not differ between angiographic patterns (P > .05).
  
  
  CONCLUSIONS
  3T high-resolution MRI combined with DSA offered clear visualization of vessel wall features and accurate assessment of the vessel lumen in IDAs. This combined approach would be highly useful for understanding the underlying pathological status of IDAs and in guiding treatment choices.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
authors.forename: Yanmin
authors.initials: Y
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Lou
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
authors.forename: Binbin
authors.initials: B
authors.lastname: Sui
authors.forename: Shengjun
authors.initials: S
authors.lastname: Sun
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Li
authors.forename: Peng
authors.initials: P
authors.lastname: Jiang
authors.forename: Adnan
authors.initials: A
authors.lastname: Siddiqui
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis*; D015901:Angiography, Digital Subtraction / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D002532:Intracranial Aneurysm / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods