Therefore, the objectives of our study were to determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of ICVA and PICA in LMI patients. In past studies, high-resolution contrast-enhanced three dimensional gradient-echo image which was used to evaluate intracranial lesion in routine clinical examinations at 3T was more reliable than MRA for detecting ICVA dissection ( 9). High-resolution contrast-enhanced MRI helps to show intracranial arterial wall which is the small size and comparatively deep location ( 8). Several reports showed usefulness of high-resolution MRI in evaluation of plaques on intracranial artery such as basilar artery or middle cerebral artery ( 4, 5, 6, 7). Recently advanced MR imaging techniques are available for detection and evaluation of atherosclerotic plaque and vessel wall in the intracranial artery. It is good to show luminal stenosis in intracranial artery in MRA, but have limitation to distinguish several diseases, which was shown as only luminal stenosis on MRA. Lumen and thickened wall of cerebral artery are well evaluated using CTA with radiation risk. But DSA is an inadequate method for screening arterial lesions due to invasiveness and the possibility of iatrogenic stroke ( 3).

Although several causes of lateral medullary infarction (LMI), such as atherosclerosis, dissection and thromboembolism in the intracranial vertebral artery (ICVA) and the posterior inferior cerebellar artery (PICA) were reported, there have been few radiological studies for ICVA and PICA in LMI as yet ( 1, 2).ĭigital subtraction angiography (DSA) is a gold standard for diagnosis of arterial lesion in ICVA and PICA together with computed tomography angiography (CTA) and magnetic resonance angiography (MRA).

Divisions of pica artery