The Emerging Role Of256-slice CT Angiography In The Diagnosis And Endovascular Therapy Of Cervical Artery Dissection

BACKGROUND AND PURPOSE:Cervical artery dissection (CAD) is an important cause of stroke in young and middle-aged patients, it can cause a variety of clinical presentations. Conventional digital subtraction angiography (DSA) has been historically considered as the gold standard for the diagnosis of cervical artery dissection, nowadays CT angiography (CTA) are commonly used as noninvasive alternatives. The goal of this study was to compare the ability of256-slice CTA, conventional angiography and MR T1-weighted fat-suppressed (MR T1-FS) images to detect common imaging findings of cervical artery dissection.MATERIALS AND METHODS:Patients between Feb2010and Mar2012with CAD assessed by DSA or MR T1-FS imaging were conducted. Radiological features of CAD on256-slice CTA were reanalyzed, including vessel stenosis, intimal flap, double lumen sign, occlusion, wall thickening/hematoma and dissecting aneurysm.RESULTS:Fifty-eight patients(40males, mean age46.9±11.9years)with a total of68dissections(29carotid arteries and39vertebrobasilar arteries) were reviewed retrospectively. Compare to DSA256-slice CTA demonstrate intimal flap in22/26(85%), the double lumen sign was detected in4/6(67%), lumen stenosis was clearly illustrated in33/35(94%). Dissecting aneurysm, vessel occlusion displayed with CTA and DSA were deemed equal. CTA can demonstrate wall thickening well compare to MR T1-FS images.CONCLUSION:Our findings confirm that256-slice CTA is capable of visualizing more features associated with dissections, which can be a quick and reliable technique in diagnosing CAD.