Initial and follow-up high-resolution vessel wall MRI study of spontaneous cervicocranial artery dissection.
Eur Radiol
; 34(3): 1704-1715, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-37670185
ABSTRACT
OBJECTIVES:
To explore the factors associated with ischemic stroke secondary to spontaneous cervicocranial artery dissection (sCCAD) and evaluate the initial imaging markers related to outcomes.METHODS:
Initial and follow-up high-resolution vessel wall MRI (VW-MRI) in consecutive patients with sCCAD were retrospectively analyzed. The associations of clinical and imaging factors and variants of the circle of Willis (COW) with ischemic stroke were evaluated using binary logistic regression analyses. The anatomical outcomes were categorized as complete, partial, and no remodeling based on changes of the vessel wall and lumen. Ordinal logistic regression analysis was used to assess associations between initial features and outcomes.RESULTS:
A total of 115 dissected arteries (79 strokes, 36 non-strokes) were detected in 103 patients. Follow-up VW-MRI was available in 46 patients (44.7%, with 51 vessels), with a median interval of 8.5 months. Pseudoaneurysm (odd ratio [OR], 0.178; 95% confidence interval [CI], 0.039-0.810; p = 0.026) tended to rarely cause ischemic stroke, while intraluminal thrombus (OR, 5.558; 95% CI, 1.739-17.765; p = 0.004), incomplete COW (OR, 9.309; 95% CI, 2.122-40.840; p = 0.003), and partial complete COW (OR, 4.463; 95% CI, 1.211-16.453; p = 0.025) were independently associated with stroke occurrence. Furthermore, the presence of double lumen (OR, 5.749; 95% CI, 1.358-24.361; p = 0.018) and occlusion (OR, 12.975; 95% CI, 3.022-55.645; p = 0.001) were associated with no remodeling of sCCAD.CONCLUSIONS:
Multiple initial factors were found to be related to stroke occurrence and anatomical outcomes of sCCAD. High-resolution VW-MRI may provide valuable insights into the pathophysiology and evolution of sCCAD. CLINICAL RELEVANCE STATEMENT Initial and follow-up high-resolution vessel wall MRI may help elucidate the pathophysiology of spontaneous cervicocranial artery dissection and provide important insights into the evolution and further facilitate the optimal management of patients with spontaneous cervicocranial artery dissection. KEY POINTS ⢠Clinical and imaging factors, as well as the status of primary collateral circulation, are associated with ischemic stroke secondary to spontaneous cervicocranial artery dissection. ⢠The follow-up high-resolution vessel wall MRI provides valuable insights into the long-term evolution and anatomical outcomes of spontaneous cervicocranial artery dissection. ⢠The high-resolution vessel wall MRI features related to ischemic stroke and anatomical outcomes may further facilitate the optimal management of patients with spontaneous cervicocranial artery dissection.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Accidente Cerebrovascular Isquémico
/
Disección Aórtica
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
China