Doppler ultrasound and CT angiography in the diagnosis of structural and functional abnormalities in vertebrobasilar pool
Keywords:dopplerography, vertebral arteries, vertebrobasilar insufficiency, CT angiography
Instrumental work-up of the structural-functional condition of vertebrobasilar pool vessels in syndromic vertebrobasilar insufficiency (SVI) for the determination of precise causative factor is the actual question because of choice of treatment tactic that depends on it.
Purpose: to define diagnostic facilities of doppler ultrasound and CT angiography for the structural-functional disturbance revealing in the vertebral arteries with SVI.
Methods: we examined 164 patients with the clinical sings of SVI syndrome. During the examination of vertebrobasilar pool vessels, it has been paid attention to their course, size, possibility, clearance condition.
Results: asymmetry of maximal systolic bloodstream speed in the vertebral arteries over 30 % was the persistent sign in 155 (94.5 %) patients. Objective criteria of the spinal unit damage were found in 124 (75.6 %) patients, and in 31 (18.9 %) these signes were not found, but anatomical peculiarities of the vertebral arteries were revealed — hypolasia, tortousity, that determined clinical symptoms of SVI. In 9 patients (5.5 %) objective data of structural-functional disturbance in vertebral arteries was not found. In four (2.4 %) out of them contrast brain vessels CT examination revealed building anomalies in the circle of Willis accompanied with clinical symptoms of SVI. In other 5 (3.1 %) patients SVI symptoms masked brain neurological diseases.Conclusions: features of the qualitative and quantitive measurement characteristics are defined of vertebral arteries bloodstream in the visualization of their anatomic building peculiarities, that allows to reveal pathological hemodynamic changes in vertebrobasilar pool resulting into SVI syndrome development in the cervical spine.
Ananeva N, Trofimova T. CT and MRI diagnosis of acute ischemic apoplexy. SP.: Medical Academy Posgraduated Education.
Barysh A, Doluda Ya. Symptoms and diagnosis of demeges vertebral arteries with trauma of cervical part of spine. Orthopaedics, Traumatology and Prosthetics. 2012;3(588):119–124.
Barysh A, Doluda Ya, Vishnyakov A. Correlation of clinical and sonography resuls of investigation in dependince on traumatic deformation of cervical part of spine. International Journal of Medicine. 2014;2:69–75.
Gonchar A, Gonchar I. Vertebral angiography. The News of Radiology. 1998;5:32–33.
Kadyrova L, Marchenko V. Neurological aspeccts of stenosis vertebral canal. Orthopaedics, Traumatology and Prosthetics. 2005;1:87–93.
Kalashnikov V. Vertebral artery syndrom: clinical varirty, classification, principale of diagnosis and managament .International Journal of Medicine. 2010;1:93–99.
Kapustin S. Ultrasound investigation in tables and schemes. Moskow: Triada X. 2003. 64 р.
Korzh N, Radchenco V. Digest of Trauumatology. Kiev. 2009. 504 p.
Kulikov V. Colour duplex scanning in diagnosis of vassels disease. Diagnosic Centre of Altay. 1997. 154 p.
Leluk V, Leluk S. Ultrasound angiology. Moskow 2013. 234 p.
Safronova O, Nenarochnov S, Morozov V. Possibility of ultrasound diagnosis at syndrom vertebral artery. Fundamental investigation. 2011;10(3):553–557.
Spuzyak M, Sharmazanova E. X-ray diagnostic vertebral disease. Guide. Kharkov. «Krokus», 168 р.
Abdullaev R, Hvisyuk A, Marchenco V, Kadyrova L. Ultrasound visualization and dopplerography vertebral artery at different pathology. International Journal of Medicine. 2005;1:111–115.
Hong-tao Z, Shu-ling Z, Dao-pei Z. Two case reports of bilateral vertebral artery tortuosity and spiral twisting in vascular vertigo. BMC Neurology. 2014;14:аrticle 14. doi: 10.1186/1471-2377-14-14.
Muller M, Bleeck J, Ruf M. Vertebral artery anomaly with entry at C4-avoiding a surgical pitfall: a case report. Eur. Spine J. 2008;17(2):291–293. doi: 10.1007/s00586-007-0582-9.
Park J, Kim J, Roh J. Hypoplastic vertebral artery: frequency and associa¬tions with ischaemic stroke territory. J Neurol. Neurosurg. Psychiatry. 2007;78(9):954–958. doi: 10.1136/jnnp.2006.105767.
Molinari R, Bessette M, Raich AL, Dettori JR, Molinari Ch. Vertebral artery anomaly and injury in spinal surgery. Evid. Based Spine Care J. 2014;5(1):16–27. doi: 10.1055/s-0034-1366980.
Copyright (c) 2016 Oleg Vyrva, Andrey Vishnyakov, Yaroslav Doluda, Lyubov Mischenko
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available after 6 months from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.
Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.
The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).