High-Resolution Magnetic Resonance Imaging (HR-MRI) Imaging Characteristics of Vertebral Artery Dissection with Negative MR Routine Scan and Hypoperfusion in Arterial Spin Labeling

BACKGROUND: Unruptured vertebral artery dissection (VAD) that causes ischemic infarction may require anticoagulant therapy or other treatments. However, anticoagulation therapy is not recommended for patients without ischemic infarction. To date, there has been no research on the imaging characteristics of patients with ischemic hypoperfusion that have a negative routine MRI scan. MATERIAL/METHODS: Patients with suspected VAD were recruited between June 2015 and June 2020 in order to perform high-resolution magnetic resonance imaging (HR-MRI). In total, 26 patients with negative MRI routine scans that underwent arterial spin labeling (ASL) examination were included in the study. The patients were divided into the hypoperfusion group and normal group based on whether hypoperfusion was found in ASL. The clinical features and HR-MRI features between these 2 groups were analyzed. RESULTS: There were no statistical differences between the hypoperfusion group and normal group based on the patient’s clinical characteristics (P>0.05). According to imaging characteristics between the 2 groups, the effective lumen index and the vertebrobasilar artery minimum angle were statistically significant (P<0.001). Therefore, a vertebrobasilar artery minimum angle <90° was negatively correlated to the posterior circulation ischemia hypoperfusion, with a correlation coefficient of −0.686. The effective lumen index was also negatively correlated to the posterior circulation ischemia hypoperfusion, with a correlation coefficient of −0.671. However, the location of the dissection and other HR-MRI characteristics were not statistically significant between these 2 groups (P>0.05). CONCLUSIONS: The hypoperfusion of posterior circulation ischemia caused by VAD is related to the effective lumen index, as well as the vertebrobasilar artery minimum angle.