Significance of Low Signal in Intracranial Vertebral Artery Wall Observed on Susceptibility-Weighted Angiography
Significance of Low Signal in Intracranial Vertebral Artery Wall Observed on Susceptibility-Weighted Angiography
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磁敏感加权血管造影颅内椎动脉壁低信号的意义
DOI：
10.1159/000524840
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发表时间：
2023
期刊：
影响因子：
2.9
通讯作者：
Hideki Ishimaru; Yohei Ikebe; Minoru Morikawa; Reiko Ideguchi; Yohei Tateishi; Akira Tsujino; Masataka Uetani
中科院分区：
文献类型：
--
作者：
Takanori Kouchi;Yuki Tanabe;Takaaki Hosokawa;Yuta Yamamoto;Kazuki Yoshida;Takuya Matsuda;Naoto Kawaguchi;Tomoyuki Kido;Akira Kurata;Teruhito Kido.;Hideki Ishimaru; Yohei Ikebe; Minoru Morikawa; Reiko Ideguchi; Yohei Tateishi; Akira Tsujino; Masataka Uetani
目的探讨敏感性加权血管造影观察到的颅内椎动脉管壁低信号的临床意义。材料和方法回顾性分析了200例连续后循环急性缺血性卒中患者的敏感性加权血管造影。检查和评估椎动脉壁偏心或同心低信号的存在。通过计算机断层扫描和t1加权成像（T1WI）尽可能多地调查低信号的病因。我们还比较了其在每种中风亚型中的频率。结果200例患者中有128例（64%）出现低信号。在128例患者中，74例患者T1WI显示低信号（58%），24例患者T1WI显示中低信号（n= 8）或高信号（n= 16），对应于血管壁钙化。1例低信号无血管壁增厚或钙化，29例低信号原因不明。根据脑卒中亚型，14/14（100%）椎动脉夹层低信号，均对应壁内血肿。51/65例（78%）动脉粥样硬化血栓形成低信号，明显高于心脏栓塞（34/66;52%）和小动脉疾病（18/39;46%）（p< 0.01）。在动脉粥样硬化血栓中，钙化是低信号最常见的原因（n= 32; 63%）。结论敏感性加权血管造影在椎动脉夹层和动脉粥样硬化中多见低信号，反映椎动脉夹层和动脉粥样硬化均为壁内血肿，后者以钙化为主。
PurposeWe aimed to investigate the clinical significance of the low signal in the intracranial vertebral artery wall observed on susceptibility-weighted angiography.Materials and MethodsWe retrospectively reviewed susceptibility-weighted angiographies from 200 consecutive patients with acute ischemic stroke in the posterior circulation territory. The presence of eccentric or concentric low signals in the vertebral artery wall was examined and evaluated. The etiology of the low signal was also investigated as much as possible by referring to computed tomography and T1-weighted imaging (T1WI). We also compared its frequency in each stroke subtype.ResultsA low signal was observed in 128/200 patients (64%). The low signals (58%) corresponded to vessel wall calcification in 74 of 128 patients and to vessel wall thickening showing intermediate to low (n= 8) or high (n= 16) signals on T1WI in 24 (19%) patients. The low signal did not have vessel wall thickening or calcification in 1 patient, and the cause of the low signal could not be verified in 29 patients. According to stroke subtypes, a low signal was observed in 14/14 (100%) vertebral artery dissections, all of which corresponded to intramural hematoma. A low signal was observed in 51/65 (78%) atherothromboses, which were significantly more frequent than cardioembolism (34/66; 52%) and small-artery disease (18/39; 46%)(p< 0.01). In atherothrombosis, calcification was the most common cause of low signal (n= 32; 63%).ConclusionLow signals on susceptibility-weighted angiography were frequently observed in vertebral artery dissection and atherothrombosis, reflecting intramural hematoma in all of the former and predominantly calcification in the latter.
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