Cervicocranial Artery Dissection

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Abstract
Purpose: To evaluate pulsed Doppler ultrasound and MR angiography (MRA) in the diagnosis of cervicocranial dissection. Material and Methods: Fourteen patients with cervicocranial artery dissection were examined over a 3-year period. Twelve patients had dissection of the extracranial part of the internal carotid artery, and 2 had vertebral artery dissection. All patients were examined with pulsed Doppler ultrasound. In addition, all patients had conventional angiography (n=9) and/or MR imaging including MRA (n=9). Results: Doppler ultrasound disclosed unspecific abnormalities in 11 of 14 dissected vessels; 3 patients had false-negative Doppler findings. MRA showed vessel abnormalities in 9 of 9 patients; 2 vessels were occluded, and 7 vessels had changes typical of dissection (double lumen and/or string sign). Twelve patients had follow-up examinations with pulsed Doppler ultrasound (n=12), conventional angiography (n=3), and MRA/MR (n=11). Follow-up Doppler showed complete or partial normalization in 6 of 9 patients, all confirmed by either angiography or MRA. Conclusion: Our findings suggest that Doppler ultrasound may be used in follow-up of pathologic Doppler findings in known dissections, and that MRA may replace angiography in the confirmative diagnosis of cervicocranial dissection.

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