[Assessment of vertebrobasilar insufficiency using magnetic resonance angiography]

We present the protocol for diagnosis of VBI followed by ENT and Radiology Departments of the Valencia University General Hospital, using the 2D-PC magnetic resonance angiography technique (MRA) with variable VENC (30 and 40 cm/s) with a SIGMA 1.5 T Advantage system version 5 x with the corresponding software review 5.2 (General Electric Medical Systems, Milwaukee, WI, USA). After a coronal angiographic projection is obtained in a neutral position on an axial plane of localization, the patient head is set at the maximum left and right rotation and hyperextension allowed by patient and system. In this way, a coronal angiographic sequence is obtained in order to visualize potential compressions, decreases of the flow, arterial loops, etc. MRA is a non-invasive technique that requires no contrast, does not expose the patient to ionizing radiation, and allows to change the position of the patient's head easily. Since no hospitalization is required and contraindications are minimal (e.g., implanted pacemakers...), we believe that MRA constitutes and ideal screening technique to assess the vertebro basilar system. The results obtained and the advantages provided by MRA over Doppler-ultrasound and X-ray angiography are showed.