Is it possible to recognize cervical artery dissection on stroke brain MR imaging? A matched case-control study.
1Department of Neuroradiology, Paris-Descartes University, INSERM U, Centre Hospitalier Sainte-Anne, France. o.naggara@chsainte-anne.fr
AJNR. American Journal of Neuroradiology
|April 16, 2011
Summary
Standard brain MRI can detect carotid artery dissection (CAD) in young adults, a common cause of stroke. This imaging technique aids in early diagnosis when other methods are delayed or not initially considered.
Area of Science:
- Neurology
- Radiology
- Vascular Imaging
Background:
- Extracranial carotid artery dissection (CAD) causes approximately 20% of strokes in young adults.
- Mural hematomas in cCAD and vCAD can extend into the petrous carotid segment or be distally located, respectively.
Purpose of the Study:
- To evaluate the efficacy of standard brain Magnetic Resonance (MR) imaging in the early detection of CAD in the upper carotid and vertebral arteries.
- To determine if brain MR imaging can identify mural hematomas indicative of CAD.
Main Methods:
- Retrospective analysis of a prospectively maintained stroke database for patients diagnosed with CAD.
- Review of cervical fat-suppressed T1-weighted MR sequences to identify mural hematomas within the field of view.
- Independent review of brain MR sequences by two blinded observers to confirm CAD presence, comparing cases with controls matched for age, sex, NIHSS score, and DWI stroke.
Main Results:
- Brain MR imaging correctly identified CAD in 76.6% of affected patients and correctly excluded CAD in 94.8% of controls.
- cCAD was more frequently detected by brain MR imaging (93.1%) compared to vCAD (26.3%).
Conclusions:
- Initial brain MR imaging can suggest CAD in over two-thirds of patients.
- This approach offers practical benefits for patients with stroke experiencing delayed cervical MRA or when CAD is not initially suspected.
