Acute Distal Vertebral Artery Occlusion in Patients with Asymmetrical Vertebral Artery Geometry: Role of Black-Blood-Enhanced MR Imaging

Autor: Youngsun Jeong, Chan Sol Park, Ui Yun Lee, Seung Bae Hwang, Gyung Ho Chung, Hyo Sung Kwak
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Diagnostics, Vol 12, Iss 10, p 2391 (2022)
Druh dokumentu: article
ISSN: 2075-4418
DOI: 10.3390/diagnostics12102391
Popis: Background: The purpose of this study was to evaluate the diagnostic value of contrast enhancement in a unilateral distal vertebral artery (VA) using black blood (BB)-enhanced magnetic resonance (MR) imaging in patients with acute neurological symptoms and asymmetrical VA geometry. Methods: From January 2020 to August 2021, we retrospectively analyzed BB-contrast-enhanced MR imaging and MR angiography (MRA) findings in stroke patients visiting the emergency room for an evaluation of acute neurological symptoms. We classified four patterns according to asymmetrical VA geometry using MRA and contrast enhancement using BB-enhanced MR imaging: type 1 = enhanced VA + no visualization of VA, type 2 = enhanced VA + hypoplastic VA, type 3 = non-enhanced VA + hypoplastic VA, or type 4 = non-enhanced VA + no visualization of VA. Results: In total, 288 patients (type 1 = 65, type 2 = 17, type 3 = 130, type 4 = 76) were enrolled in this study. Of these patients, 82 (28.5%) showed contrast enhancement of a unilateral distal VA on BB-enhanced MR imaging, and 51 (17.8%) had positive findings on diffusion-weighted imaging (DWI) in the ipsilateral medulla, pons, or posterior inferior cerebellar artery (PICA) territory. The contrast enhancement of a unilateral distal VA using BB-enhanced MR imaging demonstrated a significantly higher prevalence in patients with acute infarction on DWI (50.0% vs. 4.9%, p < 0.001). Conclusions: The contrast enhancement of a unilateral distal VA on BB-enhanced MR imaging is associated with acute infarction of the medulla, pons, or PICA territory and suggests acute occlusion of a distal VA.
Databáze: Directory of Open Access Journals
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