Intracranial arterial dissections in ischemic stroke assessed by 3D rotational angiography

Matsumoto, Shoji; Takada, Tatsuro; Yasaka, Masahiro; Kasuya, Junji; Yamada, Kentaro; Minematsu, Kazuo

doi:10.1016/j.jns.2010.06.010

Cited by 8 publications

(5 citation statements)

References 12 publications

(12 reference statements)

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“…But when the injection flow rate is too large, the intravascular pressure also increases, which will cause patient discomfort. According to previous reports, when the catheter tip is kept within the internal carotid artery, the injection rate used in the 3D DSA is 2–2.5 ml/s, 12 or 3–4 ml/s, 2,13 which shows that the choice of injection rate is uncertain. Now, there are few studies about CM injection protocols of 3D DSA cerebral vascular imaging.…”

Section: Discussionmentioning

confidence: 99%

“…According to the reports, when the catheter tip is kept within the internal carotid artery, the injection rate used in the 3D DSA was 2–2.5 ml/s, 12 or 3–4 ml/s. 2,13 With the wide use of 3D DSA in clinical routine, the dose of iodinated contrast agent also gradually increases, which makes people worry about the increase of the incidence of contrast-induced nephropathy (CIN) in at-risk patients.…”

Section: Introductionmentioning

confidence: 99%

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Application of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography of the intracranial aneurysm

et al. 2016

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Objective The objective of this article is to explore the feasibility of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography (3D DSA) of the intracranial aneurysm. Materials and methods Fifty-one patients with suspected intracranial aneurysms were included. The catheter tip was kept within the internal carotid artery at the epistropheus level. Patients were divided into three groups randomly according to injection rate: group A (1.5 ml/s, n = 18), group B (2.0 ml/s, n = 18), and group C (3.0 ml/s, n = 15). The noise, signal-to-noise ratio (SNR), and carrier-to-noise ratio (CNR) of C2, C6, M1, and A1 segments were calculated. The continuous subtraction images and reconstructed images were evaluated by two technicians. Results No significant differences were found in noise between groups A and B, and groups A and C. Significant differences were found in the SNR and CNR of M1 and A1 segments between groups A and B, and groups B and C, but for C2 and C6 segments, they were not significant. Significant differences were found in the SNR and CNR of all segments between groups A and C. Significant differences were found in the contrast agent dose between all three groups. No significant differences were found in scores evaluated by two physicians between the three groups. Conclusion The personalized injection protocol of low injection rate and low contrast agent dose in 3D DSA of the intracranial aneurysm is feasible. The application of this protocol can reduce the dose of iodine and obtain satisfactory images.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography of the intracranial aneurysm

et al. 2016

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“…Three-dimensional (3D) rotational angiography with a standard Integris BV5000 biplane system (Philips Medical System, Best, The Netherlands) was also performed if needed. The system provides contrast angiographic vascular luminal rotational X-ray image acquisition in multiple planes with reconstruction on a 3D work station [10]. The diagnosis of ICA dissection was made by DSA based on the review by Provenzale [11] and the criteria of the Spontaneous Cervicocephalic Arterial Dissections Study [29].…”

Section: Methodsmentioning

confidence: 99%

“…Because ICA dissection sometimes causes brain ischemia and subarachnoid hemorrhage [6], immediate vascular evaluation and treatment are necessary. Among the diagnostic tools for identifying dissections, including digital subtraction angiography (DSA) [9,10], magnetic resonance imaging (MRI) [11], magnetic resonance angiography (MRA) [12,13], computed tomography angiography (CTA) [14,15,16] and conventional transsurface carotid ultrasonography (TSCU) [17,18,19,20], TSCU is handy and safe. However, ICA dissection typically occurs at least 2 cm distal to the bifurcation, at the level of the second and third cervical vertebrae, and extends over a variable distance [3].…”

Section: Introductionmentioning

confidence: 99%

Identification of Internal Carotid Artery Dissection by Transoral Carotid Ultrasonography

Suzuki¹,

Koga

Toyoda³

et al. 2012

Cerebrovasc Dis

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Background and Purpose: Conventional transsurface carotid ultrasonography (TSCU) via the cervical surface often fails to detect dissection of the extracranial internal carotid artery (ICA). The role of transoral carotid ultrasonography (TOCU) in the detection of ICA dissection was examined. Method: Patients with unilateral extracranial ICA dissection identified by digital subtraction angiography (DSA) from our database of patients with ischemic stroke or transient ischemic attack (TIA) were reviewed. Findings of dissection were compared between TSCU and TOCU. Results: Eight patients (7 men, 37–69 years old), including 7 with ischemic stroke and 1 with TIA, had ICA dissection. By DSA, dissection was identified between the first and third vertebrae in 4 patients and from the third cervical vertebra to the intracranial level in the remaining 4. TOCU images revealed an intimal flap as definite evidence of dissection in all patients. In 7 patients, color flow signals were not seen in false lumens, indicating thrombosed lumens. Four patients showed morphological changes of dissection on follow-up TOCU, including a patient with recovery of color flow signals in false lumens. The diameter of the dissected ICA was 7.3 ± 0.7 mm and that of the contralateral ICA was 4.9 ± 0.6 mm (p = 0.008). In contrast, TSCU did not enable any conclusive findings of ICA dissection to be made in any patient. Six patients had intramural hematoma on T₁-weighted MRI, and 2 had an intimal flap with a double lumen on magnetic resonance angiography. Conclusion: TOCU has advantages over TSCU in achieving an accurate diagnosis and follow-up evaluation of ICA dissection.

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“…It is an accurate means of assessing the shape of the affected artery, providing important hemodynamic information and allowing collateral circulation to be documented [4]. Three-dimensional rotational angiography (3D-RA) provides high spatial resolution of reconstructed 3D images so that the characteristics of an artery can be assessed in cross-section [28]. Findings pathognomonic of arterial dissection (the double-lumen and/or 'pearl-and-string' sign) are observed more frequently with 3D-RA (90%) than conventional DSA.…”

Section: Digital Subtraction Angiography For the Diagnosis Of Intracrmentioning

confidence: 99%

Chinese specialist consensus on imaging diagnosis of intracranial arterial dissection

et al. 2017

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Intracranial arterial dissection is an important cause of stroke in young and middle-aged adults, but there are no domestic or globally-accepted criteria for the diagnosis and classification of intracranial arterial dissections. The evidence base for the benefits of diagnostic and interventional angiography techniques is lacking, and the imaging features of intracranial arterial dissections are not yet universally recognized or understood by clinicians. These issues influence the diagnosis and treatment of intracranial arterial dissection. Therefore, a consensus conference was convened by Neurointerventional Expert Committee of Chinese Congress of Neurological Surgeons, Chinese Interventional Neuroradiology Society of Chinese Stroke Association and Young Physicians Committee of Chinese Congress of Neurological Surgeons. The aim of this document is to report an expert consensus on the imaging diagnosis of intracranial arterial dissection. The participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. The expert consensus was intended to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.

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Intracranial arterial dissections in ischemic stroke assessed by 3D rotational angiography

Cited by 8 publications

References 12 publications

Application of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography of the intracranial aneurysm

Application of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography of the intracranial aneurysm

Identification of Internal Carotid Artery Dissection by Transoral Carotid Ultrasonography

Chinese specialist consensus on imaging diagnosis of intracranial arterial dissection

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