Journal
AGING AND DISEASE
Volume 12, Issue 8, Pages 2140-2150Publisher
INT SOC AGING & DISEASE
DOI: 10.14336/AD.2021.0502
Keywords
Craniocervical Artery Dissection; Vessel Wall MRI; DSA; Thrombus
Categories
Funding
- Beijing Natural Science Foundation [7191003]
- National Science Foundation of China [NSFC 8191101305]
- Beijing Municipal Administration of Hospitals' Ascent Plan [DFL20180602]
- National Key R&D Program of China [2017YFC1308000]
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This study showed that 3D-VWMRI has high sensitivity and specificity for identifying thrombus in patients with CCAD, and the presence of intraluminal thrombus on 3D-VWMRI is strongly associated with territorial ischemic stroke.
Patients with craniocervical artery dissection (CCAD) have a high short-term risk of ischemic stroke, which is frequently associated with thromboembolism. Previous studies have demonstrated the utility of three-dimensional vessel wall MR imaging (3D-VWMRI) in the diagnosis of dissection. Few have investigated the value of 3D-VWMRI in the detection of intraluminal thrombus. The purpose of the current study was to evaluate the added value of 3D-VWMRI for thrombus identification in patients suspected of CCAD. One hundred and four patients (mean age, 44.2 years +/- 13.2) suspected of CCAD and scheduled for digital subtraction angiography (DSA) were prospectively enrolled in the study and underwent VWMRI examination. The diagnostic performance of 3D-VWMRI for CCAD was evaluated using receiver operating characteristic (ROC) analysis with the final diagnosis results as the reference. The presence/absence of intraluminal thrombus on 3DVWMRI/DSA was independently determined. The sensitivity and specificity of 3D-VWMRI for intraluminal thrombus detection were assessed with DSA serving as the reference. The odds ratio (OR) was used to evaluate the correlation between thrombus presented on 3D-VWMRI/DSA and ischemic stroke. The 3D-VWMRI had high sensitivity (90.0%) and specificity (94.3%) in identifying arteries with CCAD. The area under the ROC curve was 0.96. With DSA as the reference, the sensitivity and accuracy of 3D-VWMRI for the detection of intraluminal thrombus were 97.4% and 79.0%, respectively. An intraluminal thrombus present on 3D-VWMRI was strongly associated with a territorial ischemic stroke (OR: 30.0; 95% confidence interval: 9.1-98.4; P < .001). In conclusion, 3D-VWMRI with a 3.0-T MR system had a high diagnostic performance for CCAD and offered added value for detecting intraluminal thrombus.
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