Changes in Vertebrobasilar Artery Dissection Visible with High-Resolution Vessel Wall Imaging: A Serial Follow-Up Study.

Diagnostics (Basel)

Department of Radiology, Research Institute of Clinical Medicine, Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea.

Published: December 2023

AI Article Synopsis

  • High-resolution vessel wall imaging (HR-VWI) is effective in detecting vertebrobasilar artery dissections (VBADs) by visualizing important features like intramural hematomas and intimal flaps.
  • A study of 15 patients with VBADs assessed changes over time through follow-up HR-VWI at 3, 6, 12, and 24 months, categorizing results into three groups based on lesion type.
  • The findings indicated that many patients demonstrated a healing process, with most showing improvements such as the disappearance of the intimal flap and double lumen over the follow-up period.

Article Abstract

Background: High-resolution vessel wall imaging (HR-VWI) can identify vertebrobasilar artery dissections (VBADs) due to its good intramural hematoma and intimal flap visualization. Although the clinical course of VBADs is known to be benign, changes in VBADs visible using HR-VWI at follow-up are unknown. Thus, this study aimed to assess serial changes in VBADs using HR-VWI at follow-up.

Materials And Methods: Patients with neurological symptoms from VBADs who had undergone both initial and follow-up HR-VWI examinations were retrospectively enrolled. Enrolled patients with VBADs at the initial HR-VWI after acute symptom onset underwent serial follow-up with HR-VWI at 3, 6, 12, and 24 months. Patients were classified into three groups based on the results of follow-up HR-VWI examinations: type 1 = wall thickness of the dissected artery; type 2 = no interval change; and type 3 = occlusion.

Results: Fifteen patients (median age: 50 years, nine males) were enrolled in this study. All patients initially showed an intimal flap and a double lumen. Twelve (80%) patients showed strong wall enhancement. Nine (60%) patients had an intramural hematoma. During serial follow-up, nine (60.0%) patients showed type 1 lesions due to attachment of the intimal flap to the vessel wall, five (33.3%) showed type 2, and one showed type 3. Four patients with BA dissection showed type 2 lesions without change in the intimal flap or the double lumen.

Conclusions: Changes in VBADs in HR-VWI were observed during the follow-up period. Most patients with VBADs showed the healing process, such as the disappearance of the intimal flap and the double lumen.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10706611PMC
http://dx.doi.org/10.3390/diagnostics13233585DOI Listing

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