TY - JOUR
T1 - Clinical and Radiological Characteristics of Intracranial Artery Dissection Using Recently Proposed Diagnostic Criteria
AU - Nakamura, Yuki
AU - Yamaguchi, Yoshitaka
AU - Makita, Naoki
AU - Morita, Yoshiaki
AU - Ide, Toshihiro
AU - Wada, Shinichi
AU - Mizoguchi, Tadataka
AU - Ikenouchi, Hajime
AU - Miwa, Kaori
AU - Yi, Kenichiro
AU - Irie, Kenichi
AU - Shimohama, Shun
AU - Ihara, Masafumi
AU - Toyoda, Kazunori
AU - Koga, Masatoshi
N1 - Funding Information:
Financial Disclosure: This study was funded by Grant-in-Aid for Scientific Research (C), JSPS KAKENHI Grant Number 16K09485. Funders played no role in the study design, collection, analysis or interpretation of data, or writing of this manuscript. Financial Disclosure: This study was funded by Grant-in-Aid for Scientific Research (C), JSPS KAKENHI Grant Number 16K09485. Funders played no role in the study design, collection, analysis or interpretation of data, or writing of this manuscript. We wish to thank Koko Asakura, PhD and Toshimitsu Hamasaki, PhD (statistical assistance). We have no disclosures relevant to the manuscript to report. Financial Disclosure: This study was funded by Grant-in-Aid for Scientific Research (C), JSPS KAKENHI Grant Number 16K09485. Funders played no role in the study design, collection, analysis or interpretation of data, or writing of this manuscript.
Funding Information:
Financial Disclosure: This study was funded by Grant-in-Aid for Scientific Research (C), JSPS KAKENHI Grant Number 16K09485 . Funders played no role in the study design, collection, analysis or interpretation of data, or writing of this manuscript.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/6
Y1 - 2019/6
N2 - Background: Data on the clinical and radiological characteristics of intracranial artery dissection (IAD) have remained limited. Our purpose was to reveal the clinical and radiological characteristics of IAD according to diagnostic criteria for IAD as recently reported by a group of international experts. Methods: Patients were retrospectively enrolled using a prospective single-center stroke registry between 2011 and 2016. Baseline characteristics and radiological findings including conventional magnetic resonance imaging (MRI) sequences, magnetic resonance angiography (MRA), high-resolution 3-dimensional T1-weighted imaging (HR-3D-T1WI), and digital subtraction angiography were reviewed. We performed statistical comparisons to determine which findings from which modalities are useful. Results: We identified 118 patients with suspected artery dissection, with 64 patients (median age, 51 [interquartile range, 45-56) years; 16 women) finally meeting the criteria for definite (n = 47), probable (n = 15), or possible (n = 2) idiopathic IAD. Ischemic stroke alone was found in 31 patients (48%) on admission. There were 36 patients (56%) suffering from hypertension and 39 (61%) with smoking history. The vertebral artery alone was the most affected in 42 patients (66%). Intramural hematoma (IMH) was more frequently detected on HR-3D-T1WI than on conventional MRI/MRA (odds ratio, 4.72; 95% confidence interval, 1.71-13.00). In 54 patients (84%), the modified Rankin Scale score after 3 months was 0-1. Conclusions: Male dominance and age at IAD onset were similar to previous studies, and more than half had hypertension and smoking history. We confirmed that HR-3D-T1WI is useful for detecting IMH in the diagnostic criteria.
AB - Background: Data on the clinical and radiological characteristics of intracranial artery dissection (IAD) have remained limited. Our purpose was to reveal the clinical and radiological characteristics of IAD according to diagnostic criteria for IAD as recently reported by a group of international experts. Methods: Patients were retrospectively enrolled using a prospective single-center stroke registry between 2011 and 2016. Baseline characteristics and radiological findings including conventional magnetic resonance imaging (MRI) sequences, magnetic resonance angiography (MRA), high-resolution 3-dimensional T1-weighted imaging (HR-3D-T1WI), and digital subtraction angiography were reviewed. We performed statistical comparisons to determine which findings from which modalities are useful. Results: We identified 118 patients with suspected artery dissection, with 64 patients (median age, 51 [interquartile range, 45-56) years; 16 women) finally meeting the criteria for definite (n = 47), probable (n = 15), or possible (n = 2) idiopathic IAD. Ischemic stroke alone was found in 31 patients (48%) on admission. There were 36 patients (56%) suffering from hypertension and 39 (61%) with smoking history. The vertebral artery alone was the most affected in 42 patients (66%). Intramural hematoma (IMH) was more frequently detected on HR-3D-T1WI than on conventional MRI/MRA (odds ratio, 4.72; 95% confidence interval, 1.71-13.00). In 54 patients (84%), the modified Rankin Scale score after 3 months was 0-1. Conclusions: Male dominance and age at IAD onset were similar to previous studies, and more than half had hypertension and smoking history. We confirmed that HR-3D-T1WI is useful for detecting IMH in the diagnostic criteria.
KW - Criteria
KW - high-resolution magnetic resonance imaging
KW - intracranial artery dissection
KW - intramural hematoma
KW - stroke
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U2 - 10.1016/j.jstrokecerebrovasdis.2019.02.019
DO - 10.1016/j.jstrokecerebrovasdis.2019.02.019
M3 - Article
C2 - 30898444
AN - SCOPUS:85063052692
VL - 28
SP - 1691
EP - 1702
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
SN - 1052-3057
IS - 6
ER -