Journal of Ultrasound in Medicine, Vol 19, Issue 4 263-270, Copyright © 2000 by American Institute of Ultrasound in Medicine
Imaging in the diagnosis and follow-up evaluation of vertebral artery dissection
C. J. Lu, Y. Sun, J. S. Jeng, K. M. Huang, B. S. Hwang, W. H. Lin, R. C. Chen and P. K. Yip
Department of Neurology, National Taiwan University Hospital, Taipei, Republic of China.
The purpose of this report is to discuss the value of ultrasonographic
examination in the diagnosis and follow-up evaluation of vertebral artery
dissection. We collected data on 8 patients with 11 pathologic vessels: 9
were affected intracranially and 6 were affected extracranially. Four
vessels were affected in both intracranial and extracranial segments.
Extracranial color-flow duplex sonography could detect abnormalities in
every extracranial vertebral artery dissection. Most abnormal findings were
non-specific, including severely reduced flow, absence of flow, and absence
of diastolic flow. A specific finding (intramural hematoma) was noted in
one artery. Abnormal transcranial color-coded sonographic findings included
absence of flow, reduced velocity and reversed flow direction. Three
intracranial dissecting arteries showed normal findings on transcranial
color-coded sonography. Ultrasonographic follow-up study revealed evidence
of improvement; this was noted almost exclusively in the extracranial
segments of the vertebral artery but infrequently in the intracranial
segment. Extracranial color-flow duplex sonography is sensitive in the
detection of extracranial vertebral artery dissection, both in initial
diagnosis and in follow-up evaluation.
