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Hyperintense Intramural Hematoma on Time-of-Flight Sequences in Carotid Dissection

We present 3D-gradient-echo time-of-flight (TOF) MR angiography images of 4 patients with internal carotid artery dissection showing hyperintense intramural hematoma resulting in stenosis ( fig. 1 ). TOF imaging has been used together with other sequences (especially fatsaturated T1and T2-weighted images) to show intramural hematoma in dissection. These different sequences are used to determine the age of the intramural hematoma radiologically [1] . Hematoma-related TOF hyperintensity has also been used recently to detect intraplaque hemorrhage. Increased TOF signal due to dissection-related intramural hematoma is best seen in the subacute phase, although hyperintensity can persist in the chronic phase like in one of our patients [2] .