E. Bartels, DISSECTION OF THE EXTRACRANIAL VERTEBRAL ARTERY - COLOR-FLOW ULTRASOUND FINDINGS IN 20 PATIENTS, Ultraschall in der Medizin, 17(2), 1996, pp. 55-63
Citations number
35
Categorie Soggetti
Radiology,Nuclear Medicine & Medical Imaging",Acoustics
Aim: To assess the diagnostic potential of duplex color-flow imaging i
n the evaluation of extracranial vertebral artery dissection. In 15 of
20 patients (75%), the dissection was related to trauma. Method: Over
the last six years, we evaluated 20 consecutive patients aged 18 to 5
9 years with 24 extracranial vertebral artery dissections (four occurr
ing bilaterally). The examinations were performed with a color Doppler
imaging system using a 7 MHz transducer. Angiography was done in 18 p
atients, confirming the diagnosis. Results: In 15 patients, the diagno
sis was primarily established with ultrasonography. Six vertebral arte
ries were dissected at the origin or in the proximal V1 segment, one i
n the distal V2 segment and one at the atlas loop. Most dissections oc
curred in the region between the V1 and V2 segments (n = 16), most oft
en at the entrance of the artery into the transverse foramen of the C6
vertebra (n = 11). Typical ultrasonographic findings were irregular s
tenosis, dissecting membrane with true and false lumen, localized incr
ease in diameter of the artery, pseudoaneurysm, intramural hematoma an
d tapering stenosis with distal occlusion. The diagnosis of dissection
in the V3 segment was based on indirect signs such as high resistance
flow pattern and decreased diastolic flow velocity. In follow-up exam
inations, marked resolution of pathological findings was found in 17 c
ases (70.8%). Two occlusions were completely recanalized. Conclusion:
Duplex color-flow imaging is a valuable noninvasive method for early d
iagnosis of extracranial vertebral artery dissection and for follow-up
examinations.