MRI-based separation of congenital and acquired vertebrobasilar artery anomalies in ischemic stroke of the posterior circulation.

Abstract:

BACKGROUND AND PURPOSE:Stroke MRI protocols provide useful information about underlying vessel pathologies in the anterior circulation by means of intracranial time-of-flight angiography. However, these protocols mostly fail in the posterior circulation to differentiate between congenital variants and secondary thrombosis. Therefore, a high-resolution anatomic True Fast Imaging in Steady State Precession sequence, added to a commonly used stroke imaging protocol, was evaluated. METHODS:MRIs of all emergency admissions to the stroke unit over 2 months were analyzed. Variations in the posterior circulation as displayed by time-of-flight and by the True Fast Imaging in Steady State Precession sequence, respectively, were graded by 2 readers blinded to the diagnosis. RESULTS:In the time-of-flight angiography, 50% of patients presented with distinctive vertebrobasilar alterations. Half of these were judged as high-grade anomalies, of which the True Fast Imaging in Steady State Precession sequence identified 25% as hypoplasia. In 40% of all patients with posterior ischemia, the True Fast Imaging in Steady State Precession sequence confirmed an acquired occlusion of the vertebrobasilar arteries. CONCLUSIONS:The addition of an anatomic (True Fast Imaging in Steady State Precession) to a functional sequence (time-of-flight) in stroke MRI protocols enables the differentiation between artery occlusions and hypoplastic variants of the vertebral arteries.

journal_name

Stroke

journal_title

Stroke

authors

Freund W,Kassubek J,Aschoff AJ,Huber R

doi

10.1161/STROKEAHA.107.512772

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

2382-4

issue

8

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.107.512772

journal_volume

39

pub_type

信件

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