Practical value of three-dimensional high resolution magnetic resonance Vessel Wall imaging in identifying suspicious intracranial vertebrobasilar dissecting aneurysms

摘要

Patient 2. A 51-year-old man complained of dizziness and extremities weakness. Initial MRI was performed 11 days after symptom onset. Catheter angiography showed a lesion with a pear-and-string appearance ( , white arrow [ ]) in the left intracranial vertebral artery and a lesion with aneurysmal dilation appearance ( , black arrow [ ]) in the right side. VWI can be used for detecting the dissecting signs of both lesions simultaneously (a1-a5 for left side, b1-b2 for right side). Long-axis view of the lesion of left side revealed intimal flap and double lumen signs (a1, spotty line) on both the dilation and stenosis segments. Pre-contrast (a2, arrow) and post-contrast (a3, arrow) VWI showed intimal flap conspicuously on the dilation segment of left side (reconstructed at spotty line showed in a1). On the stenosis segment, intimal flap and double lumen was not detected on pre-contrast image (only eccentric wall thickness, a4, arrow) but on post-contrast image (a5, arrow). Long-axis view (b1, spotty line) and short-axis view (b2, arrow) of the lesion of right side revealed intimal flap and double lumen signs obviously