Förster Alex, Kerl Hans U, Wenz Holger, Mürle Bettina, Habich Sonia, Groden Christoph
Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
J Neuroimaging. 2015 Jul-Aug;25(4):608-13. doi: 10.1111/jon.12177. Epub 2014 Oct 18.
Vertebrobasilar dolichoectasia (VBD) is a dilatative arteriopathy associated with a decreased blood flow velocity. Fluid attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is a phenomenon most likely representing slow arterial blood flow. We sought to examine the frequency and extent of FVH in VBD.
We analyzed magnetic resonance imaging (MRI) findings in 77 VBD patients with special emphasis on FVH in relation to the diagnostic MRI criteria of VBD and the etiology in symptomatic patients.
In 49 (63.6%) VBD patients, FVH could be detected: in 22 (44.9%) a small hyperintense rim near the vessel wall (grade 1), in 20 (40.8%) a strong hyperintense rim near the vessel wall (grade 2), and in 7 (14.3%) the hyperintense signal filled the complete vessel lumen (grade 3). The diameter of the basilar artery moderately correlated with the extent of FVH. A higher FVH grade (2 and 3) was more common in patients with TIA/stroke related to VBD (9/16 [56.3%]) in comparison to patients with other etiology and asymptomatic patients (18/61 [29.5%]; P = .046).
FVH may be useful to demonstrate the decreased blood flow velocity in VBD. More pronounced FVH in patients with posterior circulation TIA/stroke might reflect the underlying stroke pathomechanism.
椎基底动脉延长扩张症（VBD）是一种与血流速度降低相关的扩张性动脉病变。液体衰减反转恢复（FLAIR）血管高信号（FVH）是一种最有可能代表动脉血流缓慢的现象。我们试图研究VBD中FVH的频率和范围。
我们分析了77例VBD患者的磁共振成像（MRI）结果，特别关注FVH与VBD的诊断MRI标准以及有症状患者病因之间的关系。
在49例（63.6%）VBD患者中可检测到FVH：22例（44.9%）在血管壁附近有小的高信号边缘（1级），20例（40.8%）在血管壁附近有强烈的高信号边缘（2级），7例（14.3%）高信号充满整个血管腔（3级）。基底动脉直径与FVH范围中度相关。与其他病因患者和无症状患者相比，与VBD相关的短暂性脑缺血发作（TIA）/卒中患者中更高等级的FVH（2级和3级）更为常见（9/16 [56.3%] 对比18/61 [29.5%]；P = 0.046）。
FVH可能有助于证明VBD中的血流速度降低。后循环TIA/卒中患者中更明显的FVH可能反映潜在的卒中发病机制。
