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Published in: Journal of Medical Ultrasonics 1/2019

01-01-2019 | Original Article

Color Doppler ultrasonography is a reliable diagnostic tool in the diagnosis of extracranial vertebral artery dissections

Authors: Cengiz Yılmaz, Feride Fatma Gorgulu, Fatma Yasemin Oksuzler, Muhammet Arslan, Mahmut Oksuzler, Sakir Ozgur Keskek, Ayse Selcan Koc

Published in: Journal of Medical Ultrasonics | Issue 1/2019

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Abstract

The purpose of this study was to evaluate the role of color Doppler sonography (CDS) in the diagnosis of extracranial vertebral artery dissections (EVADs). One hundred and fifty consecutive patients (age range 21–51 years, mean 44 years) with a clinical suspicion of vertebral artery dissection (VAD) were included in this study. All patients underwent CDS of vertebral arteries as the first-line imaging modality. Cervical T1-weighted fat-saturated axial MR images served as the gold standard. Of the 150 patients with a clinical suspicion of VAD, 27 patients were ultimately diagnosed with EVADs based on fat-saturated T1-weighted MR imaging. MR imaging was considered positive when crescentic hyperintensity (methemoglobin signal) was demonstrated at the wall of the vertebral artery. CDS was positive in 21 of these 27 patients and revealed either intramural hematoma or a dissecting membrane with two lumina. The most frequent site of involvement was the V1 to proximal V2 segment. The sensitivity, specificity, and positive and negative predictive values of CDS in the diagnosis of EVADs were 77.8, 98.4, 91.3, and 95.3%, respectively. CDS is a reliable diagnostic tool in the diagnosis of EVADs.
Literature
1.
go back to reference Gottesman RF, Sharma P, Robinson KA, et al. Clinical characteristics of symptomatic vertebral artery dissection. A Systematic Review. Neurologist. 2012;18:245–54.CrossRefPubMedPubMedCentral Gottesman RF, Sharma P, Robinson KA, et al. Clinical characteristics of symptomatic vertebral artery dissection. A Systematic Review. Neurologist. 2012;18:245–54.CrossRefPubMedPubMedCentral
2.
go back to reference Vertinsky AT, Schwartz NE, Fischbein NJ, et al. Comparasion of multidetector CT angiography and MR imaging of cervical artery dissection. Am J Neuroradiol. 2008;29:1753–60.CrossRef Vertinsky AT, Schwartz NE, Fischbein NJ, et al. Comparasion of multidetector CT angiography and MR imaging of cervical artery dissection. Am J Neuroradiol. 2008;29:1753–60.CrossRef
3.
go back to reference Lu JC, Sun Y, Jeng JS, et al. Imaging in the diagnosis and follow-up evaluation of vertebral artery dissection. J Ultrasound Med. 2000;19:263–70.CrossRefPubMed Lu JC, Sun Y, Jeng JS, et al. Imaging in the diagnosis and follow-up evaluation of vertebral artery dissection. J Ultrasound Med. 2000;19:263–70.CrossRefPubMed
4.
go back to reference Bartels E, Flügel KA. Evaluation of extracranial vertebral artery dissection with duplex color-flow imaging. Stroke. 1996;27:290–5.CrossRefPubMed Bartels E, Flügel KA. Evaluation of extracranial vertebral artery dissection with duplex color-flow imaging. Stroke. 1996;27:290–5.CrossRefPubMed
5.
go back to reference Yang L, Ran H. Extracranial vertebral artery dissection: findings and advantages of ultrasonography. Medicine (Baltimore). 2018;97:e0067.CrossRef Yang L, Ran H. Extracranial vertebral artery dissection: findings and advantages of ultrasonography. Medicine (Baltimore). 2018;97:e0067.CrossRef
6.
go back to reference Rodallec MH, Marteau V, Gerber S, et al. Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. RadioGraphics. 2008;28:1711–28.CrossRefPubMed Rodallec MH, Marteau V, Gerber S, et al. Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. RadioGraphics. 2008;28:1711–28.CrossRefPubMed
7.
go back to reference Flis CM, Jäger HR, Sidhu PS. Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment. Eur Radiol. 2007;17:820–34.CrossRefPubMed Flis CM, Jäger HR, Sidhu PS. Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment. Eur Radiol. 2007;17:820–34.CrossRefPubMed
8.
go back to reference Pugliese F, Crusco F, Cardaioli G, et al. CT ahgiography versus colour-Doppler US in acute dissection of the vertebral artery. Radiol. Med. 2007;112:435–43.CrossRefPubMed Pugliese F, Crusco F, Cardaioli G, et al. CT ahgiography versus colour-Doppler US in acute dissection of the vertebral artery. Radiol. Med. 2007;112:435–43.CrossRefPubMed
9.
go back to reference Wessels T, Mosso M, Krings T, et al. Extracranial and intracranial vertebral artery dissection: long term clinical and duplex sonographic follow-up. J Clin Ultrasound. 2008;36:472–9.CrossRefPubMed Wessels T, Mosso M, Krings T, et al. Extracranial and intracranial vertebral artery dissection: long term clinical and duplex sonographic follow-up. J Clin Ultrasound. 2008;36:472–9.CrossRefPubMed
10.
11.
go back to reference Siepmann T, Borchert M, Barlinn K. Vertebral artery dissection with compelling evidence on duplex ultrasound presenting only with neck pain. Neuropsychiatr Dis Treat. 2016;1:2839–41.CrossRef Siepmann T, Borchert M, Barlinn K. Vertebral artery dissection with compelling evidence on duplex ultrasound presenting only with neck pain. Neuropsychiatr Dis Treat. 2016;1:2839–41.CrossRef
12.
13.
go back to reference Provenzale JM. MRI and MRA for evaluation of dissection of craniocerebral arteries: lessons from the medical literature. Emerg Radiol. 2009;16:185–93.CrossRefPubMed Provenzale JM. MRI and MRA for evaluation of dissection of craniocerebral arteries: lessons from the medical literature. Emerg Radiol. 2009;16:185–93.CrossRefPubMed
14.
go back to reference Siepmann T, Borchert M, Barlinn K. Vertebral artery dissection with compelling evidence on duplex ultrasound presenting only with neck pain. Neuropsychiatr Dis Treat. 2016;1:2839–41.CrossRef Siepmann T, Borchert M, Barlinn K. Vertebral artery dissection with compelling evidence on duplex ultrasound presenting only with neck pain. Neuropsychiatr Dis Treat. 2016;1:2839–41.CrossRef
Metadata
Title
Color Doppler ultrasonography is a reliable diagnostic tool in the diagnosis of extracranial vertebral artery dissections
Authors
Cengiz Yılmaz
Feride Fatma Gorgulu
Fatma Yasemin Oksuzler
Muhammet Arslan
Mahmut Oksuzler
Sakir Ozgur Keskek
Ayse Selcan Koc
Publication date
01-01-2019
Publisher
Springer Singapore
Published in
Journal of Medical Ultrasonics / Issue 1/2019
Print ISSN: 1346-4523
Electronic ISSN: 1613-2254
DOI
https://doi.org/10.1007/s10396-018-0901-2

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