Abstract
Arteriosclerosis of the vertebral artery preferentially affects the area near its origin, and sometimes can become a cause of embolism. The purpose of this study was assess the validity of conventional color Doppler sonography compared to selective angiography for evaluating the origin of the vertebral artery. A retrospective study of 120 vertebral arteries was undertaken. Sixty patients with cerebrovascular disorders were studied by conventional color Doppler sonography and selective arterial angiography. The lesions were classified into 6 groups morphologically on the basis of angiography: normal, hypoplastic, occluded, kinked, coiled and stenosed. Color Doppler imaging enabled good documentation of vertebral artery flow on the right in 93% and on the left in 97%, and of the vertebral artery wall on the right in 70% and on the left in 52 (<0.05). Occlusion and hypoplasty were detected in all 15 vessels with a specificity of 94.3%, but false positive results were obtained in one vessel due to technical difficulties. Thirteen of these 15 vessels were kinked and coiled. Moderate stenosis (<70%) could not be evaluated, but stenosis exceeding 80% was diagnosed in two cases with a specificity of 100%. Diagnosis of moderate stenosis of the origin of the vertebral artery remains difficult. Duplex sonography seems a viable option for evaluation of the vertebral artery, and for quantifying vertebro-basilar stroke.
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