Kuruma T*, Arimoto M, Yo K, Kawade Y, Kondo A, Uchida Y, Ogawa T and Fujimoto Y
Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Aichi, JapanFulltext PDF
Background: The purpose of this study was to confirm whether the 3-dimensional hemodynamics of the vertebrobasilar artery system can be evaluated using a combination of ultrasonography, head and neck Magnetic Resonance Imaging (MRI), and Magnetic Resonance Angiography (MRA) as a diagnostic method for Vertebrobasilar Insufficiency (VBI). Materials and Methods: Subjects were 40 patients with suspected VBI based on clinical symptoms seen between January 2016 and December 2017 (22 males, 18 females; mean age, 78.1 years). Cervical ultrasonography and MRI and MRA of the head and neck were performed on all patients. Changes in VA blood flow in the mid-neck and cervical rotation positions were also measured and compared. We compared blood flow status of the vertebral artery measured by cervical ultrasonography with morphological changes such as stenosis and occlusion of the vertebral artery measured by MRI and MRA. Results: Eight patients showed VA blood flow changes in cervical rotation on cervical ultrasonography. Of these patients, three had normal cervical ultrasound in the mid-neck position with no problems with VA blood flow, and 3 patients showed no problems on MRA. Of the 17 patients with no VA occlusion on cervical ultrasonography, MRI showed internal carotid artery lesions in 6 cases and VA dissection in 1 case, while MRA showed VA lesions in 6 cases. Conclusion: In the diagnosis of VBI, we considered that cervical ultrasonography alone is insufficient, but in combination with MRA can help to construct a 3-dimensional picture of blood flow dynamics in the patient.
Vertebrobasilar Insufficiency (VBI); Ultrasonography; MRI; MRA
Kuruma T, Arimoto M, Yo K, Kawade Y, Kondo A, Uchida Y, et al. Usefulness of Duplex Color-Coded Ultrasonography in the Cervical Rotational Position in Combination with Head MRI and MRA for the Diagnosis of Vertebrobasilar Insufficiency. Am J Otolaryngol Head Neck Surg. 2022; 5(7): 1198.