CERVICOCRANIAL ARTERY DISSECTION - DETECTION BY DOPPLER ULTRASOUND AND MR-ANGIOGRAPHY

Purpose: To evaluate pulsed Doppler ultrasound and MR angiography (MRA ) in the diagnosis of cervicocranial dissection. Material and Methods: Fourteen patients with cervicocranial artery dissection were examined over a 3-year period. Twelve patients had dissection of the extracran ial part of the internal carotid artery, and 2 had vertebral artery di ssection. All patients were examined with pulsed Doppler ultrasound. I n addition, all patients had conventional angiography (n=9) and/or MR imaging including MRA (n=9). Results: Doppler ultrasound disclosed uns pecific abnormalities in 11 of 14 dissected vessels; 3 patients had fa lse-negative Doppler findings. MRA showed vessel abnormalities in 9 of 9 patients; 2 vessels were occluded, and 7 vessels had changes typica l of dissection (double lumen and/or string sign). Twelve patients had follow-up examinations with pulsed Doppler ultrasound (n=12), convent ional angiography (n=3), and MRA/MR (n=11). Follow-up Doppler showed c omplete or partial normalization in 6 of 9 patients, all confirmed by either angiography or MRA. Conclusion: Our findings suggest that Doppl er ultrasound may be used in follow-up of pathologic Doppler findings in known dissections, and that MRA may replace angiography in the conf irmative diagnosis of cervicocranial dissection.