title: Characterization of Craniocervical Artery Dissection by Simultaneous MR Noncontrast Angiography and Intraplaque Hemorrhage Imaging at 3T.
abstract: OBJECTIVE
  Craniocervical artery dissection is the most common cause of ischemic stroke identified in young adults. For the diagnosis of craniocervical artery dissection, multisequence MR imaging is recommended but is time-consuming. Recently, investigators proposed a simultaneous noncontrast angiography and intraplaque hemorrhage imaging technique allowing simultaneous noncontrast MRA and vessel wall imaging in a single scan. This study sought to investigate the feasibility of 3D simultaneous noncontrast angiography and intraplaque hemorrhage MR imaging in the characterization of craniocervical artery dissection.
  
  
  METHODS
  Twenty-four symptomatic patients (mean age, 45.0 ± 16.1 years; 21 men) with suspected craniocervical artery dissection were recruited. The 3D simultaneous noncontrast angiography and intraplaque hemorrhage 3D TOF MRA and black-blood imaging sequences were performed on a 3T MR imaging scanner. The agreement between simultaneous noncontrast angiography and intraplaque hemorrhage imaging and multisequence MR imaging in evaluating arterial dissection was determined.
  
  
  RESULTS
  Dissection was found to involve 1 artery in 22 patients and 2 arteries in 2 patients. The intramural hematoma and luminal occlusion were detected in 19 (79.2%) and 11 (45.8%) patients, respectively. In measuring stenosis, the Cohen κ value between 3D TOF MRA and simultaneous noncontrast angiography and intraplaque hemorrhage imaging was 0.82 (P < .001). All intramural hematomas on multisequence imaging were successfully identified by simultaneous noncontrast angiography and intraplaque hemorrhage imaging.
  
  
  CONCLUSIONS
  3D simultaneous noncontrast angiography and intraplaque hemorrhage imaging showed excellent agreement with multisequence MR imaging in evaluating luminal stenosis and intramural hematoma in patients with craniocervical artery dissection. The simultaneous noncontrast angiography and intraplaque hemorrhage imaging saved nearly 50% of scanning time compared with multisequence MR imaging. Our findings suggest that 3D simultaneous noncontrast angiography and intraplaque hemorrhage imaging might be an alternative, time-efficient diagnostic tool for craniocervical artery dissection.
authors.affiliation: From the Departments of Neurology (Q.L., X.G., D.M., X.Z.) Department of Neurology (Q.L.), People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.affiliation: Clinical Sites Research Program (J.W.), Philips Research North America, Briarcliff Manor, New York.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Biomedical Engineering (H.C., L.H., Z.C., R.L., C.Y., X.H.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.affiliation: From the Departments of Neurology (Q.L., X.G., D.M., X.Z.).
authors.forename: X
authors.initials: X
authors.lastname: Gong
authors.affiliation: Interventional Neuroradiology (N.M., K.G.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: N
authors.initials: N
authors.lastname: Ma
authors.affiliation: Interventional Neuroradiology (N.M., K.G.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: K
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of Biomedical Engineering (H.C., L.H., Z.C., R.L., C.Y., X.H.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Radiology (M.G.), Yangzhou First People's Hospital, Yangzhou, China.
authors.forename: M
authors.initials: M
authors.lastname: Guan
authors.affiliation: Department of Biomedical Engineering (H.C., L.H., Z.C., R.L., C.Y., X.H.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Biomedical Engineering (H.C., L.H., Z.C., R.L., C.Y., X.H.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China.
authors.forename: R
authors.initials: R
authors.lastname: Li
authors.affiliation: From the Departments of Neurology (Q.L., X.G., D.M., X.Z.).
authors.forename: D
authors.initials: D
authors.lastname: Mi
authors.affiliation: Department of Biomedical Engineering (H.C., L.H., Z.C., R.L., C.Y., X.H.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China Department of Radiology (C.Y.), University of Washington, Seattle, Washington.
authors.forename: C
authors.initials: C
authors.lastname: Yuan
authors.affiliation: From the Departments of Neurology (Q.L., X.G., D.M., X.Z.) xihaizhao@tsinghua.edu.cn zxq@vip.163.com.
authors.forename: X
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Biomedical Engineering (H.C., L.H., Z.C., R.L., C.Y., X.H.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China xihaizhao@tsinghua.edu.cn zxq@vip.163.com.
authors.forename: X H
authors.initials: XH
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*