Learning objectives
To illustrate the most frequent imaging features of internal carotid artery (ICA) and vertebral artery (VA) dissection on computed tomography and computed tomography angiography (CT/CTA),
magnetic resonance imaging/angiography (MRI/MRA) and digital subtraction angiography (DSA).
To review the epidemiology and typical clinical presentation of ICA and VA dissection.
To discuss the pitfalls in the diagnosis of ICA and VA dissection.
Background
Arterial dissection refers to the formation of a tear in the intima layer of the vessel and blood enters and tracks along the media layer of the artery ( Fig. 1) .
Cervical arterial dissection (CAD) may affect ICA and/or VA. CAD is a common cause of ischemic stroke in young and middle-aged people although it is rare in the overall population.
Even dissection could be located in the all segments of ICA and VA extracranial segments are more likely affected especially the cervical part...
Findings and procedure details
The radiologists should search for CAD findings at the neuroimaging procedures such as lumen-opacifying methods (CTA/ MRA/ DSA) and cross-sectional procedures (CT/MRI) when clinical features are suspicious for dissection.
Dissections can present as stenosis,
occlusion,
or aneurysmal dilatation at the CTA,
DSA,
and MRA. CT and MRI can be helpful to show the intramural hematoma at the vessel wall.
The sensitivity and specificity of MR-MRA and CT-CTA in the diagnosis of CAD are relatively similar to DSA.
It seems logical to start with non-invasive techniques...
Conclusion
Cervical arterial dissection is one of the important causes of ischemic stroke in young and middle-age patients.
It may lead to severe disability without early diagnosis and treatment.
Knowing the typical imaging findings in CTA,
MRI/MRA and DSA isessential for the radiologist in order to appropriately diagnose dissection.
Personal information
Contact Details:
Dilara Atasoy
Karadeniz Technical University Faculty of Medicine
Farabi Hospital
Department of Radiology
E-mail:
[email protected]
Author Information:
Dilara Atasoy,
Department of Radiology,
Karadeniz Technical University Faculty of Medicine,
Trabzon,
Turkey
E-mail:
[email protected]
İlker Eyüboğlu,
Department of Radiology,
Karadeniz Technical University Faculty of Medicine,
Trabzon,
Turkey
E-mail:
[email protected]
Merve Erkan,
Department of Radiology,
Fatih State Hospital,
Trabzon,
Turkey
E-mail:
[email protected]
Ahmet Sarı,
Department of Radiology,
Karadeniz Technical University Faculty of Medicine,
Trabzon,
Turkey
E-mail:
[email protected]
References
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Machet A,
Edjlali-goujon M,
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Causes of Misinterpretation of Cross-Sectional...