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Isolated posterior inferior cerebellar artery dissection with ischaemic stroke: evaluating the radiological features and diagnostic feasibility of high-resolution vessel wall imaging

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dc.contributor.authorHan, M-
dc.contributor.authorChoi, JW-
dc.contributor.authorJung, WS-
dc.contributor.authorLee, JS-
dc.date.accessioned2023-03-24T06:26:54Z-
dc.date.available2023-03-24T06:26:54Z-
dc.date.issued2022-
dc.identifier.issn0009-9260-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/25087-
dc.description.abstractAIM: To evaluate the radiological features of isolated posterior inferior cerebellar artery dissection (PICAD) and the feasibility of using high-resolution vessel-wall imaging (HR-VWI) for diagnosing PICAD. MATERIALS AND METHODS: Three hundred and nine patients with arterial dissection involving the posterior cerebral circulation, who underwent HR-VWI between March 2012 and July 2019 were reviewed retrospectively. Among them, 44 patients (14.2%) were diagnosed with isolated PICAD in consensus among a neuroradiologist, a neurointerventionist, and a neurologist. Two neuroradiologists reviewed the vessel wall images independently for evidence of dissection (dissection flap, outer diameter enlargement on T2-weighted imaging [WI], mural haematoma). Diagnostic confidence was also scored on a five-point scale. Intra- and interobserver agreement for diagnosing PICAD and detecting evidence of dissection were evaluated. RESULTS: Dissection flaps were seen on T2WI in all cases (100%) and on contrast-enhanced T1WI in 34 patients (79.1%). Outer diameter enlargement of the steno-occlusive lesions on angiography was detected in most cases (97.7%). A mural haematoma was detected on three-dimensional (3D) contrast-enhanced motion-sensitised driven-equilibrium T1WI in 97.1% of the cases. The mean diagnostic confidence score derived by two neuroradiologists was 4.72. The two reviewers showed substantial to almost perfect agreement (weighted kappa coefficient: 0.62-0.97). CONCLUSION: Use of HR-VWI as a diagnostic tool for PICAD is feasible, and a dissection flap with outer wall enlargement on HR-T2WI allows confident dissection diagnosis. The present data suggest that PICAD might be considered as a stroke aetiology in patients with unexplained ischaemic stroke in the PICA territory, and that PICA evaluation with HR-VWI is both necessary and feasible.-
dc.language.isoen-
dc.subject.MESHBrain Ischemia-
dc.subject.MESHFeasibility Studies-
dc.subject.MESHHematoma-
dc.subject.MESHHumans-
dc.subject.MESHIschemic Stroke-
dc.subject.MESHMagnetic Resonance Angiography-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHStroke-
dc.subject.MESHVertebral Artery-
dc.titleIsolated posterior inferior cerebellar artery dissection with ischaemic stroke: evaluating the radiological features and diagnostic feasibility of high-resolution vessel wall imaging-
dc.typeArticle-
dc.identifier.pmid35676104-
dc.contributor.affiliatedAuthorHan, M-
dc.contributor.affiliatedAuthorChoi, JW-
dc.contributor.affiliatedAuthorJung, WS-
dc.contributor.affiliatedAuthorLee, JS-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.crad.2022.05.004-
dc.citation.titleClinical radiology-
dc.citation.volume77-
dc.citation.number8-
dc.citation.date2022-
dc.citation.startPage584-
dc.citation.endPage591-
dc.identifier.bibliographicCitationClinical radiology, 77(8). : 584-591, 2022-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1365-229X-
dc.relation.journalidJ000099260-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
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