OBJECTIVES: Cervicocerebral artery dissection (CAD) is one of the important causes for ischemic stroke in young and middle-aged people. CAD is dangerous and untimely diagnosis and treatment are likely to result in severe disability. Early diagnosis and timely intervention can greatly improve the prognosis of patients. This study was to investigate the imaging features of CAD on high-resolution magnetic resonance vessel wall imaging (HRMR-VWI) and to analyze the influential factors of vascular recanalization. METHODS: A total of 19 CAD patients with both baseline HRMR-VWI and follow-up data of vascular imaging in the period from April 2017 to December 2019 in Department of Radiology, Xiangya Hospital, Central South University were retrospectively analyzed. The diseased vessels were divided into a recovery group and a unrecovered group. After treatment, diseased vessels with no residual arterial dissection and no residual stenosis in the lumen were included in the recovery group. Diseased vessels with stenosis, occlusion or residual dissection were included in the unrecovered group. Diseased vessels were divided into a ischemic stroke group and a non-ischemic stroke group according to the presence or absence of ischemic stroke in the area supplied by the diseased vessels. Differences in clinical data and HRMR-VWI imaging findings were compared between the groups. RESULTS: A total of 26 vessels were involved, including 14 (53.8%) internal carotid artery extracranial segment, 8 (30.8%) vertebral artery extracranial segment, 3 (11.5%) vertebral artery intracranial segment, and 1 (3.9%) basilar artery. Ischemic stroke occurred in 16 diseased vascular supply areas. Intramural hematoma was all observed in the baseline HMR-VWI of the affected vessels. There were 18 vessels (69.2%) in the recovery group and 8 vessels (30.8%) in the unrecovered group. Compared with the vessels in the recovery group, the vessels in the unrecovered group were mostly found in the intracranial segment ( CONCLUSIONS Intramural hematoma is a common imaging manifestation of CAD and can be shown clearly and accurately on HRMR-VWI. Recanalization rate of CAD is high, and the recanalization of CAD in intracranial segment is slower than that of CAD in extracranial segment, which can prolong the review time.
Basilar Artery ; Dissection ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Middle Aged ; Retrospective Studies ; Stroke

Objective To evaluate the diagnostic performance of 1.5-T non-contrast free-breathing whole-heart magnetic resonance coronary angiography(MRCA)for≥50% and≥70% coronary artery stenosis in coronary artery disease(CAD).Methods Forty-one patients clinically scheduled for invasive coronary angiography(ICA)underwent 1.5-T non-contrast free-breathing whole-heart MRCA.The diagnostic performance for≥50% and≥70% stenosis was evaluated and compared using ICA as a reference standard.Results MRCA was completed in all the 41 patients with the total acquisition time of(10.1 ± 2.2)min.The sensitivity,specificity,and accuracy of MRCA for≥50% and≥70% stenosis were 100%(95%
Coronary Angiography ; Coronary Stenosis/diagnostic imaging* ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Spectroscopy ; Predictive Value of Tests ; Sensitivity and Specificity

Objective: To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features. Methods: From November 2017 to July 2020, 21 patients with sudden deafness in the People's Hospital of Dongsheng District, Ordos City were selected as the research objects, including 14 males and 7 females, aged 36-76 years, with a median age of 50 years. The course of disease was 1-19 days, with an average of 5.5 days. The patients received audiology tests, laboratory examination, and intravenous gadolinium angiography, each of whom was scanned twice by 3D-FLAIR sequence: once before intravenous gadolinium injection, and once again 4.5-6.0 h after intravenous gadolinium injection. The following corresponding clinical treatment was given. The imaging manifestations and clinical features were observed. Results: Among 21 cases of sudden deafness in acute stage, the signal intensity of 11 cases was significantly higher than that of the contralateral ear, and 2 cases had vestibular labyrinthine hydrops. In laboratory examination, only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate, and the rest had no abnormality. The hearing types of 21 patients with sudden deafness were: total deafness in 8 cases, flat decline in 10 cases, low frequency decline in 1 case, high frequency decline in 2 cases. The total effective rate was 57% (12/21). The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases, flat decline in 5 cases and high frequency decline in 1 case. The total effective rate was 64% (7/11). Conclusion: Gadolinium angiography is abnormal in some patients with sudden deafness, and the permeability of blood labyrinth barrier may be increased, which is worthy of further study.
Angiography ; Deafness ; Female ; Gadolinium ; Hearing Loss, Sudden/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Vestibule, Labyrinth

OBJECTIVE: To investigate the presentation of susceptibility vessel sign (SVS) in subacute stroke patients with large vessel occlusion. METHODS: We collected consecutive stroke patients who were admitted to Peking University First Hospital from December 2017 to August 2019 retrospectively. Those who had intracranial large vessel occlusion and received sensitivity weighted imaging (SWI) within 3 to 14 days after stroke onset were included in our analysis. The diagnosis of large vessel occlusion was based on magnetic resonance angiography (MRA), CT angiography (CTA) or digital subtraction angiography (DSA). The demographic information, clinical characteristics and imaging results were obtained from medical record. The occurrence rates of SVS sign were compared between stroke patients with cardioembolism (CE) and large artery atherosclerosis (LAA). In the sensitivity analysis, we performed a subgroup analysis in those patients who received SWI within 7 to 14 days after stroke onset. We also compared the occurrence rate of SVS sign between the patients with and without atrial fibrillation. RESULTS: A total of 51 patients, 19 females and 32 males, with an average age of (63.04±11.23) years were analyzed in this study. Compared with LAA group, the patients in CE group were older and more likely to have an atrial fibrillation (P < 0.05). There were no significant differences between the CE group and LAA group in gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, smoking, or National Institute of Health stroke scale(NIHSS) score at admission. SVS sign was found in 30 patients. Of whom, 3 were in CE group and 27 in LAA group. The occurrence rate of SVS sign was higher in the LAA group than in the CE group significantly (65.9% vs. 30.0%, P=0.039). The subgroup analysis showed that, in the patients who received SWI examination within 7 to 14 days after stroke onset, the differences between the two groups were still statistically significant (0 vs. 72.7%, P=0.006). Another sensitivity analysis showed that, the rate of SVS in the patients with atrial fibrillation was significantly lower than those patients without atrial fibrillation (25% vs. 65.1%, P=0.043). CONCLUSION In subacute stroke patients, the occurrence rate of SVS sign in CE group was lower than that of LAA group. The significance of SVS sign in the differentiation of stroke subtype needs further validation.
Aged ; Arteries ; Atherosclerosis ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Retrospective Studies ; Stroke/diagnostic imaging*

To evaluate the feasibility of non-contrast-enhanced magnetic resonance angiography (NCE-MRA) on a 3.0T scanner. Totally 36 volunteers and 24 patients with clinically suspected coronary artery disease underwent NCE-MRA. The quality of the NCE-MRA images was graded for each segment on a four-point scale. The subjects were divided into two groups according to image quality. The age,body mass index (BMI),heart rate,end-expiratory diaphragm displacement,and respiratory diaphragm motion amplitude were evaluated and compared. The average image quality score of every segment was above 2 points. The proximal and middle segments of left anterior descending artery had significantly higher quality scores than the distal segments (=0.000) and the proximal segment of left circumflex coronary artery had significantly higher quality scores than the distal segments (=0.000),the proximal segment of right coronary artery also had a significant higher quality score than its distal segment (=0.001). The image quality was good in 38 subjects (64.4%). The heart rate [(66.35±9.39) beat/min (75.32±11.67) beat/min] (=0.002) and the body mass index [(24.72±3.33) kg/m (27.82±3.61) kg/m ] (=0.002) were significantly different between the good image quality group and the poor image quality group. The end-expiratory diaphragm displacement in good image quality group was (4.43±2.07)mm,which was significantly lower than that in poor image quality group [(9.26±7.62)mm](=0.013). The respiratory diaphragm motion amplitude [(21.35±6.02) mm] in good image quality group was significantly lower than that in poor image quality group [(30.68±14.20)mm](=0.012). NCE-MRA on 3.0T is a feasible tool for visualization of the proximal and middle segments of coronary arteries,and the image quality can be optimized by controlling heart rate and respiration in the future.
Contrast Media ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; Coronary Vessels ; diagnostic imaging ; Feasibility Studies ; Humans ; Magnetic Resonance Angiography

The traditional classification, diagnosis, and treatment of intracranial aneurysms are based on the characteristics of their vascular lumen. However, in the past few years, some advances in MRI technology with high-resolution imaging can assess the pathology of intracranial vascular walls. Compared with traditional methods of computed tomography angiography, magnetic resonance angiograhpy, and digital subtraction angiography, high resolution magnetic resonance imaging technology can help us to newly understand the disease by directly evaluating the characteristics of vascular wall, such as aneurysm wall thickness, inflammation, enhancement, permeability and hemodynamics. At present, high-resolution magnetic resonance imaging is increasingly used in clinic to assess the rupture risk of intracranial aneurysms, which is of great significance for guiding the diagnosis and treatment of intracranial aneurysms.
Aneurysm, Ruptured/diagnostic imaging* ; Cerebral Angiography ; Humans ; Intracranial Aneurysm/diagnostic imaging* ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Risk Assessment ; Technology

magnetic resonance angiography assessment. The primary safety endpoint was the absence of serious adverse events (SAEs) up to 6 months from the procedure.RESULTS: The primary effectiveness endpoint was observed in 94.4% (51/54) aneurysms. In one patient with technical failure, the stent could not be deployed because of parent artery tortuosity; therefore, a different type of stent was used. Of the 53 aneurysms treated with the Alpha stent, complete occlusion was achieved in 64.1% (34/53) cases, and near-complete occlusion was achieved in 32.0% (17/53) cases by the 6-month follow-up. Two cases (3.7%) required retreatment because of major recurrence. In 4% (2/50) patients, SAEs, i.e., retinal artery thromboembolism and corona radiata lacunar infarction, were reported after the procedure.CONCLUSION: For endovascular treatment of unruptured, wide-necked, distal ICA aneurysms, coil embolization using the newly developed Alpha stent showed excellent procedural and mid-term clinical follow-up results in terms of effectiveness and safety.]]>
Adult ; Aneurysm ; Arteries ; Carotid Artery, Internal ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Angiography ; Parents ; Prospective Studies ; Recurrence ; Retinal Artery ; Retreatment ; Stents ; Stroke, Lacunar ; Thromboembolism

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.
Angiography ; Heart ; Insurance Coverage ; Korea ; Magnetic Resonance Imaging ; Patient Care

OBJECTIVE: Several studies have reported that periprocedural dual antiplatelet therapy lowers the incidence of thromboembolic complications (TEC) associated with coiling of unruptured aneurysms. We hypothesized that preprocedural administration of dual antiplatelet agents (aspirin and cilostazol) for 7days may reduce the risk of complications associated with diagnostic cerebral digital subtraction angiography (DSA).METHODS: We retrospectively reviewed the records of patients who underwent diagnostic cerebral DSA between September 2015 and April 2018. Of the 419 patients included (149 men, 270 women, mean age 58.5 years), 221 (72 men, 149 women, mean age 57.8 years) who underwent cerebral DSA between September 2015 and June 2016 were not premedicated with antiplatelet therapy. The remaining 198 (77 men, 121 women, mean age 59.4 years) who underwent cerebral DSA between July 2016 and April 2018 were premedicated with dual antiplatelet therapy (aspirin and cilostazol). We defined ischemic stroke as a cerebral DSA-induced complication identified on magnetic resonance imaging (MRI) among patients with neurological symptoms.RESULTS: Of the 221 patients who did not receive antiplatelet therapy, 210 (95.0%) showed no neurological symptoms; however, 11 (5.0%) developed neurological symptoms with MRI-proven ischemic stroke, which represents a TEC. Of the 198 patients who received dual antiplatelet therapy, 196 patients (99.0%) showed no evidence of TEC. The remaining 2 (1.0%) developed diplopia and motor weakness each, and MRI confirmed acute ischemic stroke (p=0.019).CONCLUSIONS: The use of dual antiplatelet agents (aspirin and cilostazol) for 7 days before DSA may reduce the risk of cerebral DSA-induced TEC.
Aneurysm ; Angiography, Digital Subtraction ; Diplopia ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Platelet Aggregation Inhibitors ; Premedication ; Retrospective Studies ; Stroke ; Thromboembolism

OBJECTIVE: Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients’ understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose.METHODS: Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-of-flight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery.RESULTS: The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0–5.0) in group I. In group II, the average response was 2.5 (range, 2.0–3.0).CONCLUSION: The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.
Aneurysm ; Humans ; Informed Consent ; Intracranial Aneurysm ; Magnetic Resonance Angiography ; Patient Education as Topic ; Printing, Three-Dimensional