Cranial Vessels Dissection Detection

Purpose

 Automated detection of acute dissection on MRI/MRA head and neck scans

Tag(s)

 dissection, vessel, artery, intramural hematoma, neck, head

Panel

Neuroradiology

Define-AI ID

 21030022

Originator

 Mohammed Moshebah
Lead Mohammed Moshebah

Panel Chair

 Alexander Norbash

Panel Reviewers

 Neuroradiology Panel

License

 Creative Commons 4.0
Status Published
RadElement Set(s) RDES192
                               

Clinical Implementation

Value Proposition

The rapid detection and diagnosis of intracranial and extracranial arterial dissections can be challenging due to a wide spectrum of imaging presentations. The presence of an arterial dissection has a significant impact on patient care. An algorithm able to accurately and quickly detect acute arterial dissections can expedite management and aid radiologists in expediting final imaging results.

Narrative(s)

A 50-year-old woman presents to the emergency department with acutely worsening neck pain, nausea, vertigo, and headaches following chiropractic manipulation.  She is evaluated by the ED physician who is concerned for an acute stroke. A brain attack MRI protocol that includes an MRA angiogram of the head and neck is ordered and performed. Once the MRA is complete, an algorithm immediately evaluates the head and neck arteries and flags any cases on the PACS that have imaging findings suspicious for an acute arterial dissection.

Workflow Description

The flow-enhanced and/or contrast enhanced MRA images as well as the anatomic T1-weighted fat-suppressed anatomic images acquired on the MRI scanner are synchronously sent directly to the AI engine and to PACS. The images are then analyzed by the AI engine and an alert is sent to PACS flagging any cases that have imaging findings concerning for an arterial dissection.


Considerations for Dataset Development

Procedure

MRA head and neck (without or with intravenous contrast)

Sex at birth

Male, Female

Age

0-99

Presence of Dissection

2D or 3D anatomic fat-saturated T1-weighted MRI of the neck: T1-hyperintense intramural hematoma (typically crescent shaped and adjacent to T1-hypointense intraluminal flow void)

2D or 3D MRA (without or with contrast): Vessel tapering, stenosis, aneurysmal dilatation, pseudoaneurysm of dissected cervical or intracranial artery

Technical Specifications

Inputs

 

DICOM Study

Procedure

MRI/MRA

Data Type

DICOM

Modality

MR

Body Region

head, neck


Primary Outputs

Cranial vessel wall dissection detection

RadElement ID

RDE1279

Definition

Presence of dissection

Data Type

Categorical

Value Set

  • present

  • absent

  • indeterminate

Units

N/A

Secondary Outputs

Location of dissection

RadElement ID

RDE1280

Definition

Location of dissection

Data Type

Categorical

Value Set

  • left common carotid artery

  • right common carotid artery

  • left internal carotid artery

  • right internal carotid artery

  • left vertebral artery

  • right vertebral artery

  • basilar artery

  • left middle cerebral artery

  • right middle cerebral artery

  • left anterior cerebral artery

  • right anterior cerebral artery

  • left posterior cerebral artery

  • right posterior cerebral artery

Units

N/A


Future Development Ideas

  • Direct comparison of the current MRI/MRA exams to prior or follow up exams to determine improvement/progression of dissection, stenosis, and/or pseudoaneurysm formation.

  • Accurately measuring the length of the dissection and estimating the true lumen diameter.

Related Datasets

No known related public datasets at this time, please alert us if you know of any.