title: Detection of vessel wall lesions in spontaneous symptomatic vertebrobasilar artery dissection using T1-weighted 3-dimensional imaging.
abstract: BACKGROUND
  Spontaneous intracranial vertebrobasilar artery dissection (iVBD) is a cause of ischemic stroke and subarachnoid hemorrhage in young adults that can be detected noninvasively by using multisequence magnetic resonance imaging (MRI). However, MRI findings are sometimes difficult to interpret, and its accuracy tends to be suboptimal, especially during the acute period. Therefore, we investigated whether 3-dimensional (3D) vessel wall imaging (VWI) technique could readily detect iVBD lesions in acute phase patients.
  
  
  METHODS
  Sixteen consecutive patients with acute ischemic stroke caused by iVBD were prospectively examined with a 1.5-T magnetic resonance scanner. T1-weighted (T1W) 3D-VWI was obtained using a flow-sensitized 3D fast spin-echo technique. In addition, multisequence MRI comprising magnetic resonance angiography (MRA), basiparallel anatomical scanning (BPAS), and axial T1W imaging (T1WI) were also examined. Presence of luminal stenosis, aneurysmal dilatation, intramural high signal, and intimal flap/double lumen of the vertebral and basilar arteries were visually assessed using each technique.
  
  
  RESULTS
  On 3D-VWI, luminal stenosis, aneurysmal dilatation, intramural high signal, and intimal flap were observed in 16 (100%), 11 (68.8%), 16 (100%), and 1 (6.3%) patients, respectively. In contrast, on conventional techniques, these findings were observed in 15 (93.8%, MRA with BPAS), 12 (75.0%, MRA with BPAS), 12 (75.0%, T1WI), and 12 (75.0%, MRA) patients, respectively.
  
  
  CONCLUSIONS
  The T1W 3D-VWI can directly visualize vessel wall iVBD lesions during the acute period of stroke compared with multisequence MRI.
authors.affiliation: Department of Neurology and Gerontology, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan. Electronic address: tnatori@iwate-med.ac.jp.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Natori
authors.affiliation: Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: GE Healthcare Japan, Hino, Japan.
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Miyoshi
authors.affiliation: Department of Neurology and Gerontology, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohba
authors.affiliation: Department of Neurology and Gerontology, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan.
authors.forename: Mao Yamaguchi
authors.initials: MY
authors.lastname: Oura
authors.affiliation: Department of Neurology and Gerontology, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Narumi
authors.affiliation: Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Harada
authors.affiliation: GE Healthcare Japan, Hino, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kabasawa
authors.affiliation: Department of Neurology and Gerontology, Institute for Biomedical Sciences, Iwate Medical University, Morioka, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis*; D001488:Basilar Artery / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014711:Vertebral Artery / Q000473:pathology*; D020217:Vertebral Artery Dissection / Q000175:diagnosis*
keywords: 3D vessel wall imaging; Acute stroke; magnetic resonance imaging; vertebrobasilar artery dissection