Diagnostic capability of high resolution MRI at 3.0 T with a dedicated surface coil in patients with suspected cervical artery dissection (CAD)

Purpose: To assess the diagnostic capability of 3.0T high-resolution arterial wall imaging (HR-MRI) in pts with suspected CAD.

Methods: 11 patients underwent cervical MRI at 1.5 T (T1w-TSE, T2w-TSE, CE-MRA) and HR-MRI at 3.0T (Gyroscan Intera, Philips). HR-MRI was acquired using a phased array coil with four circular elements allowing for imaging of carotid and vertebral arteries. The HR-MRI-protocol consisted of: 1) bright blood 3D inflow MRA (TR/TE/FA=25 ms/3.1 ms/16°, 120 slices, reconstructed voxel size 0.3×0.3×0.8mm); 2) black blood cardiac gated water selective T1w 3D spoiled GE (TR/TE/FA=31 ms/7.7 ms/15°, 36 slices, 0.3×0.3×1.0mm); 3) black blood cardiac triggered fat suppressed T2w TSE (TR/TE/ETL=three heart beats/44 ms/7, 18 slices, 0.3×0.3×2mm).

Results: HR-MRI provided excellent delineation of the vessel wall, due to nearly complete suppression of arterial blood signal. In 4 pts findings were normal at both studies. In 3 pts dissection diagnosed at 1.5-MRI was confirmed by HR-MRI. However, HR-MRI yielded much better delineation of vessel wall boundary; also clearer distinction between intramural hematoma and thrombus was possible. In 2 pts vessel occlusion was confirmed. In 1 pt a pseudoaneurysmen of the vertebral artery was detected only at HR-MRI and in 1 pt an intramural hematoma was clearly visible at HR-MRI, not discernible at 1.5-MRI.

Conclusion: HR-MRI permitted excellent analysis of morphological features of CAD. Furthermore, additional clinical relevant information could be gained in 2 pts. Thus, HR-MRI at 3.0T is a very promising tool for the assessment of vessel wall pathology in patients with CAD.