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In the 18 patients with both imaging studies at baseline,angiography revealed 30 dissected vessels while MRI detected 27(90%).In the target group of 9 patients,initial MR identified 15 of the 17 dissections diagnosed with angiography.Serial MR revealed completely healing in 5 vessels,improvement in 6 vessels,no change in 4 vessels,and worsening in 2 vessels.The radiographic features most likely to resolve were stenosis and mural hematoma,while occlusion and luminal irregularity tended to persist. Late ischemic events occurred in 2 patients,both with persistent MRI evidence of dissection,one while subtherapeutic on warfarin therapy and the other occurring 1 week after warfarin was discontinued.MR is a reliable noninvasive method for following the vascular response to treatment and may guide the course of a clinical trial comparing medical therapies for carotid and vertebral artery stenosis. |
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arterial dissection
arterial dissection,carotid
arterial dissection,vertebral
MRI
MRI,abnormal
MRI,angiography
MRI,serial
prognosis
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