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Utility of cone-beam computed tomography angiography for the assessment of vertebral artery dissection

Kenji Fukuda1, Toshio Higashi1, Masakazu Okawa1

  • 1Department of Neurosurgery, Fukuoka University Hospital, and School of Medicine, Fukuoka University, Fukuoka, Japan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|December 20, 2017
PubMed

Insights

Cone-beam CT angiography (CBCT-A) offers superior visualization of vertebral artery dissection (VAD) intimal flaps compared to other methods. While MRI excels at detecting intramural hematomas, CBCT-A provides detailed luminal and wall morphology for accurate VAD diagnosis.

Area of Science:

  • Vascular imaging
  • Neurology
  • Radiology

Background:

  • Vertebral artery dissection (VAD) is a significant cause of stroke and headache.
  • Accurate imaging is crucial for managing VAD.
  • Conventional modalities include catheter-based angiography, CT angiography (CTA), and MRI.

Purpose of the Study:

  • To compare cone-beam CT angiography (CBCT-A) with other imaging modalities for evaluating VAD.
  • To assess the detailed luminal and wall structures of VAD using CBCT-A.

Main Methods:

  • Retrospective study of 25 VAD cases.
  • Comparison of 2D/3D digital subtraction angiography (DSA), CTA, MRI, and CBCT-A.
  • Evaluation of intimal flap/double lumen, wall thickening, and outer wall enhancement.

Main Results:

  • CBCT-A demonstrated superior detection of intimal flaps/double lumens (56%) due to high spatial resolution.
  • MRI was superior for intramural hematoma detection (76% wall thickening).
  • CBCT-A identified outer wall enhancement in 5 cases where other modalities did not.

Conclusions:

  • CBCT-A provides detailed luminal and wall morphology of VADs.
  • CBCT-A is a valuable tool for the accurate diagnosis of vertebral artery dissection.

Keywords:
Cone-beam computed tomography angiographyEnhancement of outer wallIntimal flap/double lumenVertebral artery dissectionWall thickening/intramural hematoma

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