Elijovich Lucas, Kazmi Khuram, Gauvrit Jean Yves, Law Meng
Department of Neurology, NYU Medical Center, New York, NY 10016, USA.
Neuroradiology. 2006 Sep;48(9):606-12. doi: 10.1007/s00234-006-0100-5. Epub 2006 Jun 3.
Cervical artery dissection is an important cause of ischemic stroke, particularly in young patients. The diagnosis can be made with invasive catheter angiography or non-invasive imaging, either with MRI in conjunction with MR angiography (MRA) or CT angiography (CTA). Both modalities have been shown to have a high specificity and sensitivity. New developments such as multi-slice CTA (MSCTA) are emerging as an alternative methods for imaging the cervical and intracranial arteries. However, the contribution of modern MSCTA to carotid artery dissection has not been reported.
We present a retrospective series of seven patients in whom both MSCTA and cervical axial T1 MRI and MRA were performed in the acute to subacute setting of internal carotid artery dissection.
Carotid artery dissection was identified in all seven patients by MSCTA. The combination of MRI and MRA identified dissection in five of the seven patients. Additionally, a pseudoaneurysm was identified by MSCTA that was missed by MRI and MRA.
Our findings confirm that MSCTA is a complementary technique in comparison to cervical axial T1 MRI and cervical MRA for diagnosing carotid artery dissection, and at times may provide additional information that can impact patient management.
颈动脉夹层是缺血性卒中的重要病因，在年轻患者中尤为常见。诊断可通过有创导管血管造影或无创成像进行，后者可采用磁共振成像（MRI）联合磁共振血管造影（MRA）或CT血管造影（CTA）。这两种方式均已被证明具有高特异性和敏感性。多层CTA（MSCTA）等新进展正在成为一种用于颈内和颅内动脉成像的替代方法。然而，现代MSCTA对颈动脉夹层的作用尚未见报道。
我们回顾性分析了7例患者，这些患者在颈内动脉夹层的急性期至亚急性期均接受了MSCTA及颈部轴向T1 MRI和MRA检查。
所有7例患者通过MSCTA均确诊为颈动脉夹层。MRI和MRA联合检查在7例患者中的5例中发现了夹层。此外，MSCTA发现了1例假性动脉瘤，而MRI和MRA未发现。
我们的研究结果证实，与颈部轴向T1 MRI和颈部MRA相比，MSCTA是诊断颈动脉夹层的一种补充技术，有时可能提供可影响患者管理的额外信息。
