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Fig. 2 | BMC Neurology

Fig. 2

From: Practical value of three-dimensional high resolution magnetic resonance Vessel Wall imaging in identifying suspicious intracranial vertebrobasilar dissecting aneurysms

Fig. 2

Similar angiographic finding (fusiform or aneurysmal dilation) had different pathognomonic findings on VWI. a-d, Patient 21. A 59-year-old man had suffered right side weakness and dysphagia for 20 days with final diagnosis of segmental ectasia. Catheter angiography showed fusiform dilation of the lumen without direct dissection signs (a, arrow). VWI also showed luminal dilation without intraluminal or extraluminal thrombus formation on pre-contrast (b, arrow) and post-contrast (c, d, arrow) images. e-h, Patient 13. A 40-year-old man had unconsciousness for 4 h with final diagnosis of dissection. Catheter angiography showed local dilation of the lumen (E, arrow) without direct dissection signs. VWI showed intimal flap and double lumen signs obscurely on pre-contrast (f, arrow) image, but obviously on post-contrast images (g, h, arrow). i-l, Patient 16. A 49-year-old man had complained recurrent dizziness for 2 years, with the symptom recurrence for 1 day. Catheter angiography also showed fusiform dilation of the lumen without direct dissection signs (i, arrow) as above cases. VWI showed mixed haematoma and intimal flap (j-k, arrow) between haematoma and signal void of flow. On the short-axis view of the haematoma demonstrated subacute blood in the chronic haematoma (L, arrow), strongly suggesting chronic dissection. m-p, Patient 6. A 66-year-old female have complained recurrent dizziness for 4 years. Catheter angiography showed a lesion with a dilation-without-stenosis appearance on the left vertebral artery (M, arrow). Short-axis view of pre-contrast (N, arrow) and post-contrast (O, arrow) VWI showed dissection with intimal flap and double lumen. Short-axis view of the lesion showed chronic and subacute haematoma (P, arrow). Post-contrast VWI showed dense and thick enhancement of the intimal flap and chronic haematoma (P, bottom row)

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