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Cervicocranial artery dissection. Detection by Doppler ultrasound and MR angiography
S J Bakke1, H J Smith, E Kerty
1Department of Radiology, National Hospital, University of Oslo, Norway.
Insights
Pulsed Doppler ultrasound can monitor known cervicocranial dissections, while MR angiography (MRA) is effective for diagnosis. MRA shows vessel abnormalities in all cases, potentially replacing conventional angiography.
Area of Science:
- Vascular imaging
- Neurology
- Radiology
Background:
- Cervicocranial artery dissection is a significant cause of stroke.
- Accurate and timely diagnosis is crucial for effective management.
- Evaluating diagnostic imaging modalities is essential for improving patient outcomes.
Purpose of the Study:
- To assess the diagnostic accuracy of pulsed Doppler ultrasound and MR angiography (MRA) for cervicocranial dissection.
- To compare the utility of these non-invasive techniques against conventional angiography.
Main Methods:
- A study of 14 patients with confirmed cervicocranial artery dissection.
- All patients underwent pulsed Doppler ultrasound.
- MR imaging including MRA and conventional angiography were performed for comparison.
Main Results:
- Pulsed Doppler ultrasound identified abnormalities in 11 of 14 dissected vessels, with 3 false negatives.
- MR angiography demonstrated abnormalities in all 9 examined patients, including occlusions and characteristic dissection signs.
- Follow-up imaging confirmed normalization in 6 of 9 patients initially assessed with Doppler ultrasound.
Conclusions:
- Doppler ultrasound is suitable for monitoring known cervicocranial dissections.
- MR angiography is a reliable alternative to conventional angiography for diagnosing cervicocranial dissection.
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 extracranial part of the internal carotid artery, and 2 had vertebral artery dissection. All patients were examined with pulsed Doppler ultrasound. In addition, all patients had conventional angiography (n = 9) and/or MR imaging including MRA (n = 9).
Results:
Doppler ultrasound disclosed unspecific abnormalities in 11 of 14 dissected vessels; 3 patients had false-negative Doppler findings. MRA showed vessel abnormalities in 9 of 9 patients; 2 vessels were occluded, and 7 vessels had changes typical of dissection (double lumen and/or string sign). Twelve patients had follow-up examinations with pulsed Doppler ultrasound (n = 12), conventional angiography (n = 3), and MRA/MR (n = 11). Follow-up Doppler showed complete or partial normalization in 6 of 9 patients, all confirmed by either angiography or MRA.
Conclusion:
Our findings suggest that Doppler ultrasound may be used in follow-up of pathologic Doppler findings in known dissections, and that MRA may replace angiography in the confirmative diagnosis of cervicocranial dissection.