Value of high resolution magnetic resonance vessel wall imaging in the diagnosis of head and neck artery dissection

Objective: To investigate the value of high resolution magnetic resonance imaging (HRMRI) in the diagnosis of head and neck artery dissection. Methods: From February 2015 to June 2017, thirty patients with head and neck artery dissection in Xuanwu Hospital were prospectively enrolled. HRMRI was performed with a 32-channel head and neck combined coil. Two neurologists diagnosed dissection based on the clinical history, laboratory tests, and conventional imaging examinations, and the diagnosis was used as a reference standard. CTA and HRMRI images were analyzed separately by two radiologists including intimal flip, intracranial hematoma and double lumen. Diagnostic accuracy of CTA and HRMRI in the detection of dissection at the segmental level was calculated. Results: (1) Thirty patients with a total of 41 segments of dissected vascular segment were diagnosed by two neurologists, including 18 segments of the internal carotid artery, 18 segments of the vertebral artery, and 5 segments of the basilar artery. (2) Using CTA 21 dissected segments were correctly diagnosed. Sensitivity of CTA was 51.2% (21/41), including 6 segments had double lumen sign. (3) Using HRMRI 39 dissected segments were correctly diagnosed. Sensitivity of HRMRI was 95.1% (39/41), including 36 segments had hematoma, and 30 segments had double lumen sign. Conclusion: Head and neck HRMRI can depict the vessel wall characteristics of dissection.The technique may become first line choice in the diagnosis and follow-up of artery dissection. (authors)