Advanced

AJNR - American Journal of Neuroradiology

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Chen, C.-J. Articles by See, L.-C. Search for Related Content PubMed PubMed Citation Articles by Chen, C.-J. Articles by See, L.-C.

Multisection CT Angiography Compared with Catheter Angiography in Diagnosing Vertebral Artery Dissection

Chi-Jen Chen^a, Ying-Chi Tseng^a, Tsong-Hai Lee^b, Hui-Ling Hsu^a and Lai-Chu See^c

^a Department of Diagnostic Radiology, E-Da Hospital/I-Shou University, Taoyuan, Taiwan, ROC
^b Department of Neurology, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan, ROC
^c Public Health and Biostatistics Center, Chang Gung University, Taoyuan, Taiwan, ROC

View larger version (101K): [in a new window]   FIG 1. Images obtained in a 53-year-old woman with a sudden onset of occipital pain and unsteady gait. a, Conventional angiogram of the left VA in an oblique projection shows alternating regions of luminal narrowing and dilatation at the V4 segment (arrows). b and c, Axial source CT angiograms show a target appearance (narrowed eccentric lumen surrounded by crescent-shaped mural thickening and an enhanced wall) at the bilateral intracranial VAs (arrows). An associated increased external diameter of the dissected artery is noted. d, MIP CT angiogram demonstrates the same picture of an alternatively narrowed and dilated lumen (black arrows) and the intramural hematoma (white arrows)

View larger version (90K): [in a new window]   FIG 2. Images obtained in a 57-year-old man with a sudden onset of severe headache and neck stiffness. a, Conventional angiogram of the right VA in a lateral projection shows a dissection aneurysm at the V4 segment (arrow). b and c, MIP CT angiograms more clearly demonstrate the multiple faces of this dissection aneurysm (arrow). d and e, Axial source CT angiograms at the level of the aneurysm and its upper part show no evidence of intramural hematoma (arrow).

View larger version (99K): [in a new window]   FIG 3. Images obtained in a 51-year-old man with a sudden onset of vertigo, nausea, vomiting, and subsequent loss of consciousness. a, Conventional angiogram of the right VA shows a smoothly tapered occlusion of the VA starting from the proximal V3 segment (arrows). b and c, MIP CT angiograms show the dissection is actually starting from the junction of V3 and V4 (black arrow) with an abrupt occlusion. The faint shadow of intramural hematoma is noted at the junction of V4 and V3-V4 junction (white arrows).

View larger version (99K): [in a new window]   FIG 4. Images obtained in a 49-year-old man with numbness of the left hand and dizziness for several days. a, Conventional angiogram of the right VA shows luminal irregularities at the intracranial verebrobasilar artery, especially the V4 segment, where alternating regions of narrowing and dilatation are noted (arrows). Luminal irregularities and occlusion were seen at the carotid systems (not shown). This is a case of atherosclerotic vascular disease. b, MIP CT angiogram shows the similar appearance of an alternatively dilated and narrowed lumen (arrows) at the V4 segment. c and d, Axial source CT angiograms at the levels of dilatation and narrowing show no evidence of mural thickening (arrow).