Ultrasound in diagnosis of vertebral artery dissection

Aim of the study was duplex ultrasound diagnostic value evaluation in the diagnosis of vertebral artery dissection at different stages of its development. There were 38 patients (24-55 years old) with extracranial vertebral artery dissection, verified by magnetic resonance imaging. Duplex ultrasound was performed to all of these patients (in the first 3 weeks, in 2, in 3, and after 3 months). 14 (37%) of 38 patients had the bilateral the vertebral artery dissection, and therefore the total number of injured arteries was 52. Most often dissection localized in V1-V2 segments (80%). Vertebral artery dissection led to lumen stenosis in 45 (86%) cases, occlusion - in one (2%) case, double lumen formation - in 6 (12%). The sensitivity of duplex ultrasound in the diagnosis of vertebral artery dissection was 92%. False-negative results were obtained in 4 (8%) cases: 2 cases in the presence of double lumen and 2 cases in the presence of dissection in V3 segment of vertebral artery. Typical ultrasound signs of vertebral artery dissection in acute and subacute stages were: vessel dilating in site of dissection (96%), intramural hematoma (87%) with vessel lumen eccentric narrowing, intimal detachment (71%), and double lumen (12%). Complete artery recanalization was found in 100% of stenotic lesion cases in 92 days (3.1 months) (median) from onset of the disease. Double lumen remained during whole follow up period (2 years). Duplex ultrasound is the valuable method for extracranial vertebral artery dissection diagnosis and can be successfully uses for recanalization follow up.

ультразвуковая диагностика, дуплексное сканирование, диссекция позвоночных артерий, интрамуральная гематома, двойной просвет, отслойка интимы, ишемический инсульт, ultrasound diagnostics, duplex ultrasound, vertebral artery dissection, intramural hematoma, double lumen, intimal detachment, ischemic stroke

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