title: Feasibility of high-resolution MR imaging for the diagnosis of intracranial vertebrobasilar artery dissection.
abstract: OBJECTIVE
  To evaluate the feasibility of high-resolution MRI (HR-MRI) for diagnosing intracranial vertebrobasilar artery dissection (VBD) and to identify the most useful imaging findings suggesting dissection.
  
  
  METHODS
  We retrospectively reviewed 50 patients with suspected intracranial VBDs who underwent HR-MRI. Two neuroradiologists independently reviewed the HR-MR images. The diagnosis based on HR-MRI was compared with the final diagnosis by consensus among the neuroradiologists, neurointerventionist, and neurologist. Two neuroradiologists also sought signs of dissection (mural hematoma, dissection flap, outer-diameter enlargement on T2WI of steno-occlusive lesions). Inter- and intraobserver agreements were analysed.
  
  
  RESULTS
  HR-MRI corroborated the final diagnosis in 47 (94%; 31 VBD and 16 non-VBD) patients. A mural haematoma was best detected on T1WI and contrast-enhanced (CE)-T1WI (54.3%). Dissection flaps were observed in almost all cases on CE-T1WI (91.4 %), and then were detected on T2WI (68.6%). Outer-diameter enlargement of the steno-occlusive lesions on angiography was detected in more than half of the cases (62.9%). The two reviewers showed almost perfect agreement for the diagnosis of VBD and detecting dissection signs on every sequence.
  
  
  CONCLUSIONS
  HR-MRI can be a useful and non-invasive diagnostic tool for intracranial VBD, and dissection flaps on CE-T1WI are the signs with the greatest diagnostic value.
  
  
  CONCLUSIONS
  Direct imaging findings of dissection were well visualised by HR-MRI. Detection of a dissection flap on CE-T1WI is the most reliable diagnostic finding. HR-MRI could be a useful diagnostic tool for intracranial VBDs.
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, 443-380, Republic of Korea.
authors.forename: Miran
authors.initials: M
authors.lastname: Han
authors.forename: Nae-Jung
authors.initials: NJ
authors.lastname: Rim
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Sun Yong
authors.initials: SY
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006406:Hematoma / Q000175:diagnosis; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D020217:Vertebral Artery Dissection / Q000175:diagnosis*
chemical_list: D003287:Contrast Media