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Age determination of vessel wall hematoma in spontaneous cervical artery dissection: a multi-sequence 3T cardiovascular magnetic resonance study.

Abstract

BACKGROUND
Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR) in determining the age of vessel wall hematoma (VWH) in patients with spontaneous cervical artery dissection (sCAD).
METHODS
35 consecutive patients (mean age 43.6 ± 9.8 years) with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome) and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images.
RESULTS
The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p < 0.001 for trend). Agreement was moderate between VWH types in our study and the previously proposed time scheme of signal evolution for cerebral hemorrhage, Cohen's kappa 0.43 (p < 0.001). There was a strong agreement of CMR VWH classification compared to the time scheme which was proposed for carotid intraplaque hematomas with Cohen's kappa of 0.74 (p < 0.001).
CONCLUSIONS
Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.

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  • Authors

    Habs M, Pfefferkorn T, Cyran CC, Grimm J, Rominger A, Hacker M, Opherk C, Reiser MF, Nikolaou K, Saam T

    Source

    Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 13: 2011 pg 76

    MeSH

    Adult
    Carotid Artery, Internal, Dissection
    Germany
    Hematoma
    Horner Syndrome
    Humans
    Image Interpretation, Computer-Assisted
    Ischemic Attack, Transient
    Magnetic Resonance Imaging
    Middle Aged
    Predictive Value of Tests
    Prospective Studies
    Time Factors
    Vertebral Artery Dissection

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22122756