Evaluating cervical artery dissections in young adults: a comparison study between high-resolution MRI and CT angiography

To compare the diagnostic values of high-resolution magnetic resonance (HR-MRI) with computed tomographic angiography (CTA) in young adults with ischemic stroke due to cervical artery dissections. Totally 42 symptomatic patients were recruited in this study. All the 42 patients underwent both HR-MRI and CTA, including 28 patients with dissections confirmed by Digital Subtraction Angiography (DSA) and 4 patients with vertebral artery dissections diagnosed by follow-up. CTA and HR-MRI images were separately and blindly analyzed by two radiologists. The sensitivity, specificity, positive and negative predictive value of HR-MRI and CTA were calculated. The receiver operating characteristic (ROC) curves and AUC of each imaging modality were generated. A total of 20 carotid artery dissections, 12 vertebral artery dissections and 10 non-dissected cervical arteries were involved. The inter-observer concordance of HR-MRI and CTA was good (κ = 0.806 vs. 0.776). The sensitivity and specificity of HR-MRI and CTA on detecting the dissections were 87.5% vs. 62.5%, and 90.0% vs. 80.0%, respectively. Area under the ROC curve of HR-MRI [0.94 (95% CI 0.86–0.97)] was greater than that of CTA [0.87 (95% CI 0.71–1.0)]. Compared to CTA, HR-MRI is more sensitive and specific for the diagnosis of cervical artery dissections in high-risk symptomatic patients. This study supports the value of HR-MRI in non-invasive diagnosis of young adults with cervical artery dissections.