J Korean Soc Magn Reson Med.  2014 Mar;18(1):17-24. 10.13104/jksmrm.2014.18.1.17.

High-Resolution Contrast-Enhanced 3D-Spoiled Gradient-Recalled Imaging for Evaluation of Intracranial Vertebral Artery and Posterior Inferior Cerebellar Artery in Lateral Medullary Infarction

• Yoon Y
• Ahn SJ
• Suh SH
• Park AY
• Chung TS

• KMID: 1683776
• DOI: http://doi.org/10.13104/jksmrm.2014.18.1.17

Abstract

PURPOSE
To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI).
MATERIALS AND METHODS
Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR.
RESULTS
Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069).
CONCLUSION
HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

Keyword

Lateral medullary infarction; Intracranial vertebral artery; Posterior inferior cerebellar artery; High-resolution contrast-enhanced magnetic resonance imaging; Diffusion-weighted magnetic resonance imaging

MeSH Terms

Arteries*
Brain
Diffusion
Ethics Committees, Research
Humans
Infarction*
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Pica
Retrospective Studies
Vertebral Artery*

Figure

• 

  Fig. 1 Subcategory of arterial lesions in intracranial vertebral artery (ICVA) on HR-CE 3D-SPGR. a. Atheroma, a lesion with low signal intensity between high signal intensity of arterial lumen and enhanced outer wall in both ICVAs. b. Dissection, two irregular high signal intensities in the arterial lumen with a low signal linear structure in between at Rt. ICVA. c. Thromboembolism, very low signal intensity of the arterial lumen with enhancement of the outer wall in Rt. ICVA.

• 

  Fig. 2 A 84-year-old lateral medullary infarction patient with left posterior inferior cerebellar arterial lesion. a. HR-CE 3D-SPGR showed focal aneurysmal dilatation in left distal posterior inferior cerebellar artery. b. Diffusion weighted image showed left lateral medullary infarction. c. Contrast-enhanced magnetic resonance angiography showed normal left vertebral artery and no visualization of posterior inferior cerebellar artery.

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