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Erschienen in: Clinical Neuroradiology 4/2014

01.12.2014 | Original Article

A Comparison of CT/CT Angiography and MRI/MR Angiography for Imaging of Vertebrobasilar Dolichoectasia

verfasst von: A. Förster, MD, J. Ssozi, MD, M. Al-Zghloul, MD, M. A. Brockmann, MD, H. U. Kerl, MD, C. Groden, MD

Erschienen in: Clinical Neuroradiology | Ausgabe 4/2014

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Abstract

Purpose

Vertebrobasilar dolichoectasia (VBD) is a rare dilatative arteriopathy predominantly affecting the basilar artery (BA) and vertebral arteries. Until today, the value of computed tomography (CT)/CT angiography (CTA) compared with magnetic resonance imaging (MRI)/time-of-flight MR angiography (TOF-MRA) has not been studied systematically.

Methods

We (1) compare CTA and TOF-MRA according to the established criteria (diameter at the mid-pons level, height, and lateral position), (2) explore the value of further CTA- and TOF-MRA-derived measures (maximum transverse diameter and length), as well as (3) explore the value of further non-contrast-enhanced MRI sequences such as T1, fluid-attenuated inversion recovery, and T2* for a detailed characterization of VBD in a series of 18 patients.

Results

Comparison of CTA and TOF-MRA revealed very good consistency of the measured diameter (Pearson’s r  = 0.994, p = 0.01) and the noted height of the BA (Kendall’s tau = 1.0, p  = 0.001). The same held true for the maximum transverse diameter (Pearson’s r = 0.988, p = 0.01) and length of the BA (Pearson’s r = 0.986, p = 0.01). In contrast to this, there was a lower agreement concerning the lateral position (Kendall’s tau = 0.866, p = 0.01). In comparison with the diameter at the mid-pons level, the maximum transverse diameter was significantly larger (p = 0.002). Luminal thrombus was detected equally well by CTA and TOF-MRA. CT was useful to detect small circumscribed calcifications, whereas MRI was advantageous to demonstrate perifocal brainstem edema.

Conclusions

We could demonstrate a substantial comparability of CT/CTA and MRI/TOF-MRA in the diagnosis of VBD. The maximum transverse diameter and length may be useful when an endovascular treatment is considered. Taking into account the different informative value of both techniques, it may be worth to perform both imaging procedures.
Literatur
1.
Zurück zum Zitat Lou M, Caplan LR. Vertebrobasilar dilatative arteriopathy (dolichoectasia). Ann N Y Acad Sci. 2010;1184:121–33.PubMedCrossRef Lou M, Caplan LR. Vertebrobasilar dilatative arteriopathy (dolichoectasia). Ann N Y Acad Sci. 2010;1184:121–33.PubMedCrossRef
2.
Zurück zum Zitat Zambrino CA, Berardinelli A, Martelli A, Vercelli P, Termine C, Lanzi G. Dolicho-vertebrobasilar abnormality and migraine-like attacks. Eur Neurol. 1999;41:10–4.PubMedCrossRef Zambrino CA, Berardinelli A, Martelli A, Vercelli P, Termine C, Lanzi G. Dolicho-vertebrobasilar abnormality and migraine-like attacks. Eur Neurol. 1999;41:10–4.PubMedCrossRef
3.
Zurück zum Zitat Silverman IE, Berman DM, Dike GL, Sung GY, Litt B, Wityk RJ. Vertebrobasilar dolichoectasia associated with Marfan syndrome. J Stroke Cerebrovasc Dis. 2000;9:196–8.PubMedCrossRef Silverman IE, Berman DM, Dike GL, Sung GY, Litt B, Wityk RJ. Vertebrobasilar dolichoectasia associated with Marfan syndrome. J Stroke Cerebrovasc Dis. 2000;9:196–8.PubMedCrossRef
4.
Zurück zum Zitat Schievink WI, Torres VE, Wiebers DO, Huston J III. Intracranial arterial dolichoectasia in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 1997;8:1298–303.PubMed Schievink WI, Torres VE, Wiebers DO, Huston J III. Intracranial arterial dolichoectasia in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 1997;8:1298–303.PubMed
5.
Zurück zum Zitat Graf S, Schischma A, Eberhardt KE, Istel R, Stiasny B, Schulze BD. Intracranial aneurysms and dolichoectasia in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant. 2002;17:819–23.PubMedCrossRef Graf S, Schischma A, Eberhardt KE, Istel R, Stiasny B, Schulze BD. Intracranial aneurysms and dolichoectasia in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant. 2002;17:819–23.PubMedCrossRef
6.
Zurück zum Zitat Mitsias P, Levine SR. Cerebrovascular complications of Fabry’s disease. Ann Neurol. 1996;40:8–17.PubMedCrossRef Mitsias P, Levine SR. Cerebrovascular complications of Fabry’s disease. Ann Neurol. 1996;40:8–17.PubMedCrossRef
7.
Zurück zum Zitat Garzuly F, Marodi L, Erdos M, Grubits J, Varga Z, Gelpi E, et al. Megadolichobasilar anomaly with thrombosis in a family with Fabry’s disease and a novel mutation in the alpha-galactosidase A gene. Brain. 2005;128:2078–83.PubMedCrossRef Garzuly F, Marodi L, Erdos M, Grubits J, Varga Z, Gelpi E, et al. Megadolichobasilar anomaly with thrombosis in a family with Fabry’s disease and a novel mutation in the alpha-galactosidase A gene. Brain. 2005;128:2078–83.PubMedCrossRef
8.
Zurück zum Zitat Mahadevan A, Tagore R, Siddappa NB, Santosh V, Yasha TC, Ranga U, et al. Giant serpentine aneurysm of vertebrobasilar artery mimicking dolichoectasia–an unusual complication of pediatric AIDS. Report of a case with review of the literature. Clin Neuropathol. 2008;27:37–52.PubMedCrossRef Mahadevan A, Tagore R, Siddappa NB, Santosh V, Yasha TC, Ranga U, et al. Giant serpentine aneurysm of vertebrobasilar artery mimicking dolichoectasia–an unusual complication of pediatric AIDS. Report of a case with review of the literature. Clin Neuropathol. 2008;27:37–52.PubMedCrossRef
9.
Zurück zum Zitat Roth C, Gaiser T, Nagelmeier I, Ruschoff J, Ferbert A. Type I neurofibromatosis and megadolichobasilar artery. Nervenarzt. 2007;78:1195–9.PubMedCrossRef Roth C, Gaiser T, Nagelmeier I, Ruschoff J, Ferbert A. Type I neurofibromatosis and megadolichobasilar artery. Nervenarzt. 2007;78:1195–9.PubMedCrossRef
10.
Zurück zum Zitat Pablo-Fernandez E, Correas-Callero E, Sierra-Hidalgo F, Posada IJ. Hemifacial spasm, vertebrobasilar dolichoectasia and neurofibromatosis type 1. J Clin Neurosci. 2012;19:1046–7.PubMedCrossRef Pablo-Fernandez E, Correas-Callero E, Sierra-Hidalgo F, Posada IJ. Hemifacial spasm, vertebrobasilar dolichoectasia and neurofibromatosis type 1. J Clin Neurosci. 2012;19:1046–7.PubMedCrossRef
11.
Zurück zum Zitat Pico F, Labreuche J, Touboul PJ, Amarenco P. Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype. Neurology. 2003;61:1736–42.PubMedCrossRef Pico F, Labreuche J, Touboul PJ, Amarenco P. Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype. Neurology. 2003;61:1736–42.PubMedCrossRef
12.
Zurück zum Zitat Lamblin N, Bauters C, Hermant X, Lablanche JM, Helbecque N, Amouyel P. Polymorphisms in the promoter regions of MMP-2, MMP-3, MMP-9 and MMP-12 genes as determinants of aneurysmal coronary artery disease. J Am Coll Cardiol. 2002;40:43–8.PubMedCrossRef Lamblin N, Bauters C, Hermant X, Lablanche JM, Helbecque N, Amouyel P. Polymorphisms in the promoter regions of MMP-2, MMP-3, MMP-9 and MMP-12 genes as determinants of aneurysmal coronary artery disease. J Am Coll Cardiol. 2002;40:43–8.PubMedCrossRef
13.
Zurück zum Zitat Pessin MS, Chimowitz MI, Levine SR, Kwan ES, Adelman LS, Earnest MP, et al. Stroke in patients with fusiform vertebrobasilar aneurysms. Neurology. 1989;39:16–21.PubMedCrossRef Pessin MS, Chimowitz MI, Levine SR, Kwan ES, Adelman LS, Earnest MP, et al. Stroke in patients with fusiform vertebrobasilar aneurysms. Neurology. 1989;39:16–21.PubMedCrossRef
14.
Zurück zum Zitat Passero S, Rossi S, Giannini F, Nuti D. Brain-stem compression 2 vertebrobasilar dolichoectasia. A multimodal electrophysiological study. Clin Neurophysiol. 2001;112:1531–9.PubMedCrossRef Passero S, Rossi S, Giannini F, Nuti D. Brain-stem compression 2 vertebrobasilar dolichoectasia. A multimodal electrophysiological study. Clin Neurophysiol. 2001;112:1531–9.PubMedCrossRef
15.
Zurück zum Zitat Ubogu EE, Zaidat OO. Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study. J Neurol Neurosurg Psychiatry. 2004;75:22–6.PubMedCentralPubMedCrossRef Ubogu EE, Zaidat OO. Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study. J Neurol Neurosurg Psychiatry. 2004;75:22–6.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Passero SG, Calchetti B, Bartalini S. Intracranial bleeding in patients with vertebrobasilar dolichoectasia. Stroke. 2005;36:1421–5.PubMedCrossRef Passero SG, Calchetti B, Bartalini S. Intracranial bleeding in patients with vertebrobasilar dolichoectasia. Stroke. 2005;36:1421–5.PubMedCrossRef
17.
Zurück zum Zitat Passero SG, Rossi S. Natural history of vertebrobasilar dolichoectasia. Neurology. 2008;70:66–72.PubMedCrossRef Passero SG, Rossi S. Natural history of vertebrobasilar dolichoectasia. Neurology. 2008;70:66–72.PubMedCrossRef
18.
Zurück zum Zitat Smoker WR, Price MJ, Keyes WD, Corbett JJ, Gentry LR. High-resolution computed tomography of the basilar artery: 1. Normal size and position. Am J Neuroradiol. 1986;7:55–60.PubMed Smoker WR, Price MJ, Keyes WD, Corbett JJ, Gentry LR. High-resolution computed tomography of the basilar artery: 1. Normal size and position. Am J Neuroradiol. 1986;7:55–60.PubMed
19.
Zurück zum Zitat Smoker WR, Corbett JJ, Gentry LR, Keyes WD, Price MJ, McKusker S. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review. Am J Neuroradiol. 1986;7:61–72.PubMed Smoker WR, Corbett JJ, Gentry LR, Keyes WD, Price MJ, McKusker S. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review. Am J Neuroradiol. 1986;7:61–72.PubMed
20.
Zurück zum Zitat Giang DW, Perlin SJ, Monajati A, Kido DJ, Hollander J. Vertebrobasilar dolichoectasia: assessment using MR. Neuroradiology. 1988;30:518–23.PubMedCrossRef Giang DW, Perlin SJ, Monajati A, Kido DJ, Hollander J. Vertebrobasilar dolichoectasia: assessment using MR. Neuroradiology. 1988;30:518–23.PubMedCrossRef
21.
Zurück zum Zitat Wu X, Xu Y, Hong B, Zhao WY, Huang QH, Liu JM. Endovascular reconstruction for treatment of vertebrobasilar dolichoectasia: Long-term outcomes. Am J Neuroradiol. 2012;34:583–8.PubMedCrossRef Wu X, Xu Y, Hong B, Zhao WY, Huang QH, Liu JM. Endovascular reconstruction for treatment of vertebrobasilar dolichoectasia: Long-term outcomes. Am J Neuroradiol. 2012;34:583–8.PubMedCrossRef
22.
Zurück zum Zitat Meckel S, McAuliffe W, Fiorella D, Taschner CA, Phatouros C, Phillips TJ, et al. Endovascular treatment of complex aneurysms at vertebrobasilar junction with flow-diverting stents: Initial experience. Neurosurgery. 2013;73(3):386–94.PubMedCrossRef Meckel S, McAuliffe W, Fiorella D, Taschner CA, Phatouros C, Phillips TJ, et al. Endovascular treatment of complex aneurysms at vertebrobasilar junction with flow-diverting stents: Initial experience. Neurosurgery. 2013;73(3):386–94.PubMedCrossRef
23.
Zurück zum Zitat Rosset A, Spadola L, Ratib O. OsiriX: an open-source software for navigating in multidimensional DICOM images. J Digit Imaging. 2004;17:205–16.PubMedCentralPubMedCrossRef Rosset A, Spadola L, Ratib O. OsiriX: an open-source software for navigating in multidimensional DICOM images. J Digit Imaging. 2004;17:205–16.PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Krings T, Alvarez H, Reinacher P, Ozanne A, Baccin CE, Gandolfo C, et al. Growth and rupture mechanism of partially thrombosed aneurysms. Interv Neuroradiol. 2007;13:117–26.PubMedCentralPubMed Krings T, Alvarez H, Reinacher P, Ozanne A, Baccin CE, Gandolfo C, et al. Growth and rupture mechanism of partially thrombosed aneurysms. Interv Neuroradiol. 2007;13:117–26.PubMedCentralPubMed
25.
Zurück zum Zitat Martin AJ, Hetts SW, Dillon WP, Higashida RT, Halbach V, Dowd CF, et al. MR imaging of partially thrombosed cerebral aneurysms: characteristics and evolution. AJNR Am J Neuroradiol. 2011;32:346–51.PubMedCentralPubMedCrossRef Martin AJ, Hetts SW, Dillon WP, Higashida RT, Halbach V, Dowd CF, et al. MR imaging of partially thrombosed cerebral aneurysms: characteristics and evolution. AJNR Am J Neuroradiol. 2011;32:346–51.PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Chavhan GB, Babyn PS, Thomas B, Shroff MM, Haacke EM. Principles, techniques, and applications of T2*-based MR imaging and its special applications. Radiographics. 2009;29:1433–49.PubMedCentralPubMedCrossRef Chavhan GB, Babyn PS, Thomas B, Shroff MM, Haacke EM. Principles, techniques, and applications of T2*-based MR imaging and its special applications. Radiographics. 2009;29:1433–49.PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Azizyan A, Sanossian N, Mogensen MA, Liebeskind DS. Fluid-attenuated inversion recovery vascular hyperintensities: an important imaging marker for cerebrovascular disease. Am J Neuroradiol. 2011;32:1771–5.PubMedCrossRef Azizyan A, Sanossian N, Mogensen MA, Liebeskind DS. Fluid-attenuated inversion recovery vascular hyperintensities: an important imaging marker for cerebrovascular disease. Am J Neuroradiol. 2011;32:1771–5.PubMedCrossRef
28.
Zurück zum Zitat Cohen JE, Gomori JM, Moscovici S, Itshayek E. Successful endovascular treatment of a growing megadolichoectasic vertebrobasilar artery aneurysm by flow diversion using the “diverter-in-stent” technique. J Clin Neurosci. 2012;19:166–70.PubMedCrossRef Cohen JE, Gomori JM, Moscovici S, Itshayek E. Successful endovascular treatment of a growing megadolichoectasic vertebrobasilar artery aneurysm by flow diversion using the “diverter-in-stent” technique. J Clin Neurosci. 2012;19:166–70.PubMedCrossRef
29.
Zurück zum Zitat Sanossian N, Saver JL, Alger JR, Kim D, Duckwiler GR, Jahan R, et al. Angiography reveals that fluid-attenuated inversion recovery vascular hyperintensities are due to slow flow, not thrombus. Am J Neuroradiol. 2009;30:564–8.PubMedCentralPubMedCrossRef Sanossian N, Saver JL, Alger JR, Kim D, Duckwiler GR, Jahan R, et al. Angiography reveals that fluid-attenuated inversion recovery vascular hyperintensities are due to slow flow, not thrombus. Am J Neuroradiol. 2009;30:564–8.PubMedCentralPubMedCrossRef
30.
Zurück zum Zitat Yoshioka K, Ishibashi S, Shiraishi A, Yokota T, Mizusawa H. Distal hyperintense vessels on FLAIR images predict large-artery stenosis in patients with transient ischemic attack. Neuroradiology. 2012;55(2):165–9.PubMedCrossRef Yoshioka K, Ishibashi S, Shiraishi A, Yokota T, Mizusawa H. Distal hyperintense vessels on FLAIR images predict large-artery stenosis in patients with transient ischemic attack. Neuroradiology. 2012;55(2):165–9.PubMedCrossRef
31.
Zurück zum Zitat Yasui T, Komiyama M, Iwai Y, Yamanaka K, Nishikawa M, Morikawa T. Evolution of incidentally-discovered fusiform aneurysms of the vertebrobasilar arterial system: neuroimaging features suggesting progressive aneurysm growth. Neurol Med Chir (Tokyo). 2001;41:523–7.CrossRef Yasui T, Komiyama M, Iwai Y, Yamanaka K, Nishikawa M, Morikawa T. Evolution of incidentally-discovered fusiform aneurysms of the vertebrobasilar arterial system: neuroimaging features suggesting progressive aneurysm growth. Neurol Med Chir (Tokyo). 2001;41:523–7.CrossRef
32.
Metadaten
Titel
A Comparison of CT/CT Angiography and MRI/MR Angiography for Imaging of Vertebrobasilar Dolichoectasia
verfasst von
A. Förster, MD
J. Ssozi, MD
M. Al-Zghloul, MD
M. A. Brockmann, MD
H. U. Kerl, MD
C. Groden, MD
Publikationsdatum
01.12.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 4/2014
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-013-0261-7

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