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High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage.
Clin Neuroradiol. 2017 Jun; 27(2):175-183.CN

Abstract

PURPOSE

Standard magnetic resonance imaging (MRI) rarely identifies the cause of hemorrhage in patients with an angiogram-negative, non-perimesencephalic subarachnoid hemorrhage (SAH). Yet up to 10 % of these patients have recurrent hemorrhage. The aim of the study was to explore the potential role of high-resolution contrast-enhanced 3-Tesla vessel wall-MRI in patients with angiogram-negative SAH.

METHODS

We performed intracranial vessel wall-MRI of the circle of Willis using a 3-Tesla scanner in consecutive patients presenting with a spontaneous, angiogram-negative, non-perimesencephalic SAH. Vessel wall-MRI included T1-, T2-, and gadolinium-enhanced T1-weighted two-dimensional black-blood sequences in multiple planes (voxel size 0.4 × 0.4 × 2.0 mm). Two neuroradiologists independently scored abnormalities of the arterial wall.

RESULTS

In all, 11 patients (mean age 59 years) underwent vessel wall-MRI. A total of seven patients had vessel wall abnormalities despite normal catheter angiography. Two patients had focal abnormalities contiguous with the outer margin of the basilar artery wall for which we considered a differential of ruptured blood blister aneurysm, thrombosed aneurysm, and loculated extramural blood from elsewhere. Two patients had arterial wall enhancement involving multiple arteries, possibly secondary to SAH. Three patients had arterial wall enhancement at sites of dural penetration, remote from the SAH, likely related to age and atherosclerotic risk factors. Vessel wall-MRI did not alter patient management in this cohort.

CONCLUSION

Vessel wall-MRI showed abnormalities in seven patients with angiogram-negative SAH. These findings did not alter patient management, but the findings may be useful for other physicians who choose to perform vessel wall-MRI in this patient population.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network and the University of Toronto, 399 Bathurst St, M5T 2S8, Toronto, ON, Canada.

Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network and the University of Toronto, 399 Bathurst St, M5T 2S8, Toronto, ON, Canada.

Division of Neurology, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON, Canada.

Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network and the University of Toronto, 399 Bathurst St, M5T 2S8, Toronto, ON, Canada.

Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network and the University of Toronto, 399 Bathurst St, M5T 2S8, Toronto, ON, Canada.

Division of Neurosurgery, Department of Surgery, University Health Network and the University of Toronto, Toronto, ON, Canada.

Departments of Diagnostic Radiology and Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.

Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network and the University of Toronto, 399 Bathurst St, M5T 2S8, Toronto, ON, Canada.

Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network and the University of Toronto, 399 Bathurst St, M5T 2S8, Toronto, ON, Canada. danny.mandell@uhn.ca.

MeSH

AdultAgedAged, 80 and overCerebral AngiographyCircle of WillisFemaleHumansImage EnhancementImage Interpretation, Computer-AssistedIntracranial AneurysmMagnetic Resonance AngiographyMaleMiddle AgedPilot ProjectsReproducibility of ResultsSensitivity and SpecificitySubarachnoid Hemorrhage

Pub Type(s)

Case Reports

Journal Article

Language

eng

PubMed ID

26608742

Citation

Coutinho, J M., et al. "High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage." Clinical Neuroradiology, vol. 27, no. 2, 2017, pp. 175-183.

Coutinho JM, Sacho RH, Schaafsma JD, et al. High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage. Clin Neuroradiol. 2017;27(2):175-183.

Coutinho, J. M., Sacho, R. H., Schaafsma, J. D., Agid, R., Krings, T., Radovanovic, I., Matouk, C. C., Mikulis, D. J., & Mandell, D. M. (2017). High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage. Clinical Neuroradiology, 27(2), 175-183. https://doi.org/10.1007/s00062-015-0484-x

Coutinho JM, et al. High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage. Clin Neuroradiol. 2017;27(2):175-183. PubMed PMID: 26608742.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage. AU - Coutinho,J M, AU - Sacho,R H, AU - Schaafsma,J D, AU - Agid,R, AU - Krings,T, AU - Radovanovic,I, AU - Matouk,C C, AU - Mikulis,D J, AU - Mandell,D M, Y1 - 2015/11/25/ PY - 2015/09/28/received PY - 2015/11/05/accepted PY - 2015/11/27/pubmed PY - 2018/3/17/medline PY - 2015/11/27/entrez KW - High-resolution vessel wall magnetic resonance imaging KW - Intracranial aneurysm KW - Magnetic resonance imaging KW - Subarachnoid Hemorrhage SP - 175 EP - 183 JF - Clinical neuroradiology JO - Clin Neuroradiol VL - 27 IS - 2 N2 - PURPOSE: Standard magnetic resonance imaging (MRI) rarely identifies the cause of hemorrhage in patients with an angiogram-negative, non-perimesencephalic subarachnoid hemorrhage (SAH). Yet up to 10 % of these patients have recurrent hemorrhage. The aim of the study was to explore the potential role of high-resolution contrast-enhanced 3-Tesla vessel wall-MRI in patients with angiogram-negative SAH. METHODS: We performed intracranial vessel wall-MRI of the circle of Willis using a 3-Tesla scanner in consecutive patients presenting with a spontaneous, angiogram-negative, non-perimesencephalic SAH. Vessel wall-MRI included T1-, T2-, and gadolinium-enhanced T1-weighted two-dimensional black-blood sequences in multiple planes (voxel size 0.4 × 0.4 × 2.0 mm). Two neuroradiologists independently scored abnormalities of the arterial wall. RESULTS: In all, 11 patients (mean age 59 years) underwent vessel wall-MRI. A total of seven patients had vessel wall abnormalities despite normal catheter angiography. Two patients had focal abnormalities contiguous with the outer margin of the basilar artery wall for which we considered a differential of ruptured blood blister aneurysm, thrombosed aneurysm, and loculated extramural blood from elsewhere. Two patients had arterial wall enhancement involving multiple arteries, possibly secondary to SAH. Three patients had arterial wall enhancement at sites of dural penetration, remote from the SAH, likely related to age and atherosclerotic risk factors. Vessel wall-MRI did not alter patient management in this cohort. CONCLUSION: Vessel wall-MRI showed abnormalities in seven patients with angiogram-negative SAH. These findings did not alter patient management, but the findings may be useful for other physicians who choose to perform vessel wall-MRI in this patient population. SN - 1869-1447 UR - https://www.unboundmedicine.com/medline/citation/26608742/High_Resolution_Vessel_Wall_Magnetic_Resonance_Imaging_in_Angiogram_Negative_Non_Perimesencephalic_Subarachnoid_Hemorrhage_ DB - PRIME DP - Unbound Medicine ER -