This study investigates the relation between the heterogeneity of intramural hematoma (IMH) on three-dimensional vessel wall MRI (3D-VWMRI) images and acute ischemic stroke in patients with proven cervical artery dissection (CAD). We found the high heterogenous IMH on 3D-VWMRI was associated with acute ischemic stroke in proven and non-occluded CAD. The heterogeneous signal of an IMH on 3D-VWMRI may indicate the asynchronous progress of CAD, possibly leading to thrombosis or hemodynamic instability, therefore results in ischemic stroke. The current finding may hold promise to better elucidate the pathophysiological mechanisms and occurrence risk of ischemic stroke for patients with CAD.
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