Article Figures & Data
Figures
- 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)
- 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).
- 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).
- 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).
Tables
Results of multisection CT angiography in diagnosing VA dissection
Catheter Angiography VA Dissection No Dissection Multisection CT angiography VA dissection 19 1 No dissection 0 48 Note.—Values for CT angiography were as follows: sensitivity, 100%; specificity, 98.0% (95% CI: 89.1, 99.9); accuracy, 98.5% (95% CI: 92.1, 100); positive predictive value, 95.0% (95% CI: 75.1, 99.9), and negative predictive value, 100%.
In this issue
Jump to section
Related Articles
Cited By...
- Vertebral artery hypoplasia and vertebral artery dissection: A hospital-based cohort study
- Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
- High-Resolution Double Inversion Recovery Black-Blood Imaging of Cervical Artery Dissection Using 3T MR Imaging
- Added Value of High-Resolution MR Imaging in the Diagnosis of Vertebral Artery Dissection
- Dissection of the internal carotid artery causing Horner syndrome and palsy of cranial nerve XII
- Recanalization of Vertebral Artery Dissection
- Vertebral Artery Dissection with a Normal-Appearing Lumen at Multisection CT Angiography: The Importance of Identifying Wall Hematoma
- B-Flow Imaging in Low Cervical Internal Carotid Artery Dissection