Detection of vertebrobasilar insufficiency by using color-coded Doppler sonography in patients with isolated vertigo

Abstract

Data regarding the use of color-coded Doppler sonography (CCDS) with transcranial insonation in screening of isolated vertigo of vascular origin is limited. The primary objective of this study was to detect vertebrobasilar insufficiency (VBI) by using color-coded Doppler sonography in patients with isolated vertigo. Methods: This study was a hospital-based cross-sectional comparative study conducted on 91 patients with isolated vertigo. All patients who fulfilled selection criteria were chosen using systemic sampling method. CCDS with transcranial insonation as well as CTA (Computed tomographic angiography) was performed when their symptoms resolve or within one week of attending the hospital. Results: In this study of 91 participants, 29.7% were found to have VBI. Mean age of patients with confirmed VBI was 65.74 ± 12.23 years while that of patients without VBI was 55.02±9.97 years. Correlation between CCDS and CTA was good in terms of detection of stenosis depending on the site of stenosis (kappa = 0.698, p < 0.0001) and strong in terms of detection of vertebrobasilar insufficiency (kappa = 0.831, p < 0.0001). Compared to CTA, CCDS was found to have sensitivity of 77.7%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 91.4%. Conclusion: The prevalence of isolated vertigo of vascular origin is significant and it is worth evaluating. CCDS with transcranial insonation has a strong overall agreement with CTA as well as high specificity and positive predictive value compared to CTA in detecting vertebrobasilar insufficiency.