Spontaneous and Unruptured Chronic Intracranial Artery Dissection : High-resolution Magnetic Resonance Imaging Findings.
OBJECTIVE
The aim of this article is to present high-resolution magnetic resonance imaging (HR-MRI) findings of chronic stage spontaneous and unruptured intracranial artery dissection (ICAD).


METHODS
From March 2012 to April 2016 a total of 29 patients (15 male and14 female, age range 37-68 years) with chronic stage spontaneous and unruptured ICAD (vertebral artery 27, posterior inferior cerebellar artery 1 and middle cerebral artery 1) were retrospectively enrolled. Patients underwent HR-MRI more than 2 months (median interval 564 days, range 69-391 days) after symptom onset and were diagnosed at symptom onset or at the first imaging acquisition, which included luminal angiography and/or HR-MRI with clinical information. The HR-MRI findings were evaluated against those of luminal angiography on the basis of the lumen wall morphology, including thickening, contrast enhancement and residual dissection.


RESULTS
The HR-MRI findings were classified into complete normalization (normal lumen and wall with or without mild enhancement, n = 6), complete normalization with minimal wall changes (focal wall thickening with enhancement but normal luminal angiography, n = 8), incomplete normalization (focal wall thickening with enhancement with dilatation and stenosis on luminal angiography, n = 4), dissecting aneurysm (fusiform aneurysm with residual dissection findings, n = 8) and occlusion (small outer arterial diameter with diffuse contrast enhancement, n = 3).


CONCLUSIONS
The use of HR-MRI can demonstrate the distinguishing morphological features of chronic stage of spontaneous and unruptured ICAD as complete normalization, complete normalization with minimal wall changes, incomplete normalization, dissecting aneurysm and occlusion.
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, 138-736, Seoul, Songpa-Gu, Republic of Korea. dynamics79@gmail.com.
Seung Chai
SC
Jung
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, 138-736, Seoul, Songpa-Gu, Republic of Korea.
Ho Sung
HS
Kim
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, 138-736, Seoul, Songpa-Gu, Republic of Korea.
Choong-Gon
CG
Choi
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, 138-736, Seoul, Songpa-Gu, Republic of Korea.
Sang Joon
SJ
Kim
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Sun U
SU
Kwon
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Dong-Wha
DW
Kang
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Jong S
JS
Kim
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014711:Vertebral Artery
Chronic dissection; Dissecting aneurysm; High-resolution magnetic resonance imaging; Intracranial artery dissection
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