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KMID : 1103720150730050292
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Journal of the Korean Society of Radiology
2015 Volume.73 No. 5 p.292 ~ p.299
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Symptomatic Isolated Middle Cerebral Artery Dissection: High Resolution MR Findings
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Byon Jung-Hee
Kwak Hyo-Sung
Chung Gyung-Ho
Hwang Seung-Bae
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Abstract
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Purpose
To perform high-resolution magnetic resonance imaging (HRMRI) and determine clinical features of patients with acute symptomatic middle cerebral artery (MCA) dissection.
Materials and Methods
Thirteen patients with acute symptomatic MCA dissection underwent HRMRI within 3 days after initial clinical onset. They also underwent routine brain MR imaging. HRMRI examinations included time-of-flight MR angiography (MRA), T2-weighted, T1-weighted, proton-density-weighted, and three-dimensional magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequences. Conventional angiography and MRA were used as reference standard to establish the diagnosis of MCA dissection. The angiographic findings and HRMRI findings such as intimal flap, double lumen, and intramural hematoma were analyzed in this study.
Results
All patients presented cerebral ischemia (median National Institutes of Health Stroke Scale score = 4, range = 0-18). String sign was seen on MRA in seven patients. However, double lumen was seen in all patients on HRMRI by intimal flap. High signal lesion on MPRAGE sequences around the dissection lumen due to intramural hematoma was seen in three patients.
Conclusion
HRMRI can be used to easily detect the wall structure of MCA such as the intimal flap and double lumen in patients with acute symptomatic MCA dissection. MPRAGE can detect hemorrhage in false lumen of MCA dissection.
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KEYWORD
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Middle Cerebral Artery, Dissection, Stroke
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