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The use of SNAP and T1-weighted VISTA in cervical artery dissection

Shuiwei Xia1, Yajie Wang2, Xianli Lv3

  • 1Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui, Zhejiang, China.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|March 2, 2022
PubMed

Insights

This study found that both simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) sequence and T1-weighted volumetric isotropic turbo spin echo acquisition (T1-w VISTA) MRI techniques are effective for diagnosing cervical artery dissection (CAD). SNAP demonstrated superior intramural hematoma-wall contrast compared to T1-w VISTA.

Area of Science:

  • Radiology
  • Vascular Imaging
  • Neurology

Background:

  • Cervical artery dissection (CAD) diagnosis can be challenging with conventional angiography.
  • Advanced MRI techniques are crucial for visualizing subtle vascular changes.

Purpose of the Study:

  • To compare the diagnostic performance of SNAP and T1-w VISTA MRI sequences for CAD.
  • To evaluate the ability of these sequences to detect key imaging features of CAD.

Main Methods:

  • Retrospective review of MRI scans (SNAP and T1-w VISTA) from 59 patients with suspected cervical artery pathologies.
  • Independent assessment of diagnostic performance against a reference standard.
  • Comparison of agreement for identifying intramural hematoma (IMH), intimal flap, and double lumen.

Main Results:

  • Both SNAP and T1-w VISTA showed good consistency with the final diagnosis (κ=0.776).
  • Sensitivity and specificity for CAD diagnosis were high for both sequences (0.978 and 0.750).
  • SNAP exhibited significantly higher IMH-wall contrast than T1-w VISTA (p<0.001).

Conclusions:

  • SNAP and T1-w VISTA sequences demonstrate comparable diagnostic performance for CAD.
  • Both MRI sequences are recommended for evaluating cervical artery dissection.
  • SNAP offers improved visualization of IMH-wall contrast.
Abstract

Keywords:
Cervical artery dissectionintramural hematomasimultaneous noncontrast angiography and intraplaque hemorrhagevolumetric isotropic turbo spin echo acquisition

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