Diagnostic utility of high resolution vessel wall MRI in the detection of cranio-cervical arterial dissection

<h3>Background and Aims</h3> Stroke is a significant health problem worldwide and is one of the major cause of morbidity and mortality. The etiology of Acute ischemic Stroke(AIS) is varied with multiple pathologies implicated. Cranio-cervical artery dissection is a significant cause of stroke in young. Vessel Wall MR Imaging(VW-MRI) is a recent imaging technique that allows for direct visualization of the vessel wall. This particular study highlights the value of Vessel wall MR Imaging in evaluation of Cranio-cervical dissection in patients with AIS. <h3>Materials and Methods</h3> This was a retrospective observational cohort study of patients with acute ischemic stroke undergoing vessel wall imaging(VWI). All patients of Acute Ischemic Stroke who presented to our department underwent a luminal angiography along with High resolution VW-MRI. Subsequently an etiological diagnosis of dissection was made before and after incorporation of VW-MRI. <h3>Results</h3> A total of 204 patients presenting with AIs were screened and after exclusion, 116 patients underwent VWI. Amongst the patients, 9 patients were deemed to have dissection on the basis of conventional luminal angiography techniques. Post the incorporation of VWI, the number of patients deemed to have dissection increased to 16 (p=0.008). The interobserver reliability for the diagnosis of dissection while utilizing VW-MRI was found to be moderate (k=0.538) <h3>Conclusion</h3> Our study suggested a potential benefit of VW-MRI in picking up patients with suspected Dissection against conventional imaging techniques.