J Korean Radiol Soc.  2007 Feb;56(2):101-107. 10.3348/jkrs.2007.56.2.101.

The Usefulness of MDCT Angiography in the Diagnosis of Vertebrobasilar Artery Dissection

• Jeon GS
• Kim HS
• Kim SY
• Shin YS
• Bang OY

• KMID: 2024489
• DOI: http://doi.org/10.3348/jkrs.2007.56.2.101

Abstract

PURPOSE
To evaluate the usefulness of MDCT angiography in the diagnosis of vertebrobasilar artery dissection.
MATERIALS AND METHODS
Between July 2003 and December 2005, 39 patients who underwent MDCT angiography and digital subtraction angiography with a history of suspicious vertebrobasilar artery dissection were selected. A blind interpretation of images was made by two observers, retrospectively. A diagnosis of dissection in MDCT angiography was made according to the following criteria: presence of an intimal flap, aneurysmal dilatation, abrupt or tapered luminal narrowing, alternatively dilated and narrowed lumen. The sensitivity and specificity of MDCT angiography in depicting vertebrobasilar artery dissection were determined.
RESULTS
43 vertebrobasilar artery dissections were diagnosed by MDCT angiography in 39 patients. The interobserver agreement was good (kappa =0.92). A diagnosis was made by the presence of an intimal flap (n=16, 36%), abrupt or tapered luminal narrowing (n=16, 36%), aneurysmal dilatation (n=13, 30%), alternatively dilated and narrow lumen (n=14, 32%). The sensitivities and specificities of MDCT angiography were 91%, 88% as determined by the first radiologist, and were 89%, 87% as determined by a second radiologist, respectively.
CONCLUSION
MDCT angiography is a useful method for the diagnosis of vertebrobasilar artery dissection.

Keyword

Vertebral arteries; Vertebral arteries, dissection; Angiography

MeSH Terms

Aneurysm
Angiography*
Angiography, Digital Subtraction
Arteries*
Diagnosis*
Dilatation
Humans
Phenobarbital
Retrospective Studies
Sensitivity and Specificity
Vertebral Artery
Phenobarbital