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The normal CT can diagnose [[subarachnoid hemorrhage]] following the intracranial vertebral artery [[dissection]], but can't provide enough definition to the artery.  The contrast CT ([[CT angiography|CTA]]) has high sensitivity (94%) and specificity (95%) to make a correct diagnosis compared against the [[Digital subtraction angiography|DSA]].<ref name="pmid12127847">Long A, Lepoutre A, Corbillon E, Branchereau A (2002) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12127847Critical review of non- or minimally invasive methods (duplex ultrasonography, MR- and CT-angiography) for evaluating stenosis of the proximal internal carotid artery.] ''Eur J Vasc Endovasc Surg'' 24 (1):43-52. PMID: [http://pubmed.gov/12127847 12127847]</ref>  And some researchs reveal that the CT-baesd score can be used in predicting the final infarct size<ref name="pmid19643923">Puetz V, Sylaja PN, Hill MD, Coutts SB, Dzialowski I, Becker U et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19643923 CT angiography source images predict final infarct extent in patients with basilar artery occlusion.] ''AJNR Am J Neuroradiol'' 30 (10):1877-83. [http://dx.doi.org/10.3174/ajnr.A1723 DOI:10.3174/ajnr.A1723] PMID: [http://pubmed.gov/19643923 19643923]</ref> and also for a prognostic assesment early ischemic injury in basilar artery occllusion.<ref name="pmid19643923">Puetz V, Sylaja PN, Hill MD, Coutts SB, Dzialowski I, Becker U et al. (2009)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19643923 CT angiography source images predict final infarct extent in patients with basilar artery occlusion.] ''AJNR Am J Neuroradiol'' 30 (10):1877-83. [http://dx.doi.org/10.3174/ajnr.A1723 DOI:10.3174/ajnr.A1723] PMID: [http://pubmed.gov/19643923 19643923]</ref><ref name="pmid18768716">Cho TH, Nighoghossian N, Tahon F, Némoz C, Hermier M, Salkine F et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18768716 Brain stem diffusion-weighted imaging lesion score: a potential marker of outcome in acute basilar artery occlusion.] ''AJNR Am J Neuroradiol'' 30 (1):194-8. [http://dx.doi.org/10.3174/ajnr.A1278 DOI:10.3174/ajnr.A1278] PMID: [http://pubmed.gov/18768716 18768716]</ref><ref name="pmid18480603">Renard D, Landragin N, Robinson A, Brunel H, Bonafe A, Heroum C et al. (2008) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18480603 MRI-based score for acute basilar artery thrombosis.] ''Cerebrovasc Dis'' 25 (6):511-6. [http://dx.doi.org/10.1159/000131668 DOI:10.1159/000131668] PMID: [http://pubmed.gov/18480603 18480603]</ref><ref name="pmid20562433">Terasawa Y, Kimura K, Iguchi Y, Kobayashi K, Aoki J, Shibazaki K et al. (2010) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20562433 Could clinical diffusion-mismatch determined using DWI ASPECTS predict neurological improvement after thrombolysis before 3 h after acute stroke?] ''J Neurol Neurosurg Psychiatry'' 81 (8):864-8. [http://dx.doi.org/10.1136/jnnp.2009.190140 DOI:10.1136/jnnp.2009.190140] PMID: [http://pubmed.gov/20562433 20562433]</ref>
The normal CT can diagnose [[subarachnoid hemorrhage]] following the intracranial vertebral artery [[dissection]], but can't provide enough definition to the artery.  The contrast CT ([[CT angiography|CTA]]) has high sensitivity (94%) and specificity (95%) to make a correct diagnosis compared against the [[Digital subtraction angiography|DSA]].<ref name="pmid12127847">Long A, Lepoutre A, Corbillon E, Branchereau A (2002) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12127847Critical review of non- or minimally invasive methods (duplex ultrasonography, MR- and CT-angiography) for evaluating stenosis of the proximal internal carotid artery.] ''Eur J Vasc Endovasc Surg'' 24 (1):43-52. PMID: [http://pubmed.gov/12127847 12127847]</ref>  And some researchs reveal that the CT-baesd score can be used in predicting the final infarct size<ref name="pmid19643923">Puetz V, Sylaja PN, Hill MD, Coutts SB, Dzialowski I, Becker U et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19643923 CT angiography source images predict final infarct extent in patients with basilar artery occlusion.] ''AJNR Am J Neuroradiol'' 30 (10):1877-83. [http://dx.doi.org/10.3174/ajnr.A1723 DOI:10.3174/ajnr.A1723] PMID: [http://pubmed.gov/19643923 19643923]</ref> and also for a prognostic assesment early ischemic injury in basilar artery occllusion.<ref name="pmid19643923">Puetz V, Sylaja PN, Hill MD, Coutts SB, Dzialowski I, Becker U et al. (2009)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19643923 CT angiography source images predict final infarct extent in patients with basilar artery occlusion.] ''AJNR Am J Neuroradiol'' 30 (10):1877-83. [http://dx.doi.org/10.3174/ajnr.A1723 DOI:10.3174/ajnr.A1723] PMID: [http://pubmed.gov/19643923 19643923]</ref><ref name="pmid18768716">Cho TH, Nighoghossian N, Tahon F, Némoz C, Hermier M, Salkine F et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18768716 Brain stem diffusion-weighted imaging lesion score: a potential marker of outcome in acute basilar artery occlusion.] ''AJNR Am J Neuroradiol'' 30 (1):194-8. [http://dx.doi.org/10.3174/ajnr.A1278 DOI:10.3174/ajnr.A1278] PMID: [http://pubmed.gov/18768716 18768716]</ref><ref name="pmid18480603">Renard D, Landragin N, Robinson A, Brunel H, Bonafe A, Heroum C et al. (2008) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18480603 MRI-based score for acute basilar artery thrombosis.] ''Cerebrovasc Dis'' 25 (6):511-6. [http://dx.doi.org/10.1159/000131668 DOI:10.1159/000131668] PMID: [http://pubmed.gov/18480603 18480603]</ref><ref name="pmid20562433">Terasawa Y, Kimura K, Iguchi Y, Kobayashi K, Aoki J, Shibazaki K et al. (2010) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20562433 Could clinical diffusion-mismatch determined using DWI ASPECTS predict neurological improvement after thrombolysis before 3 h after acute stroke?] ''J Neurol Neurosurg Psychiatry'' 81 (8):864-8. [http://dx.doi.org/10.1136/jnnp.2009.190140 DOI:10.1136/jnnp.2009.190140] PMID: [http://pubmed.gov/20562433 20562433]</ref>


[[Image:CT of vertebrobasilar.jpg]]
[[File:CT of vertebrobasilar.jpg|400px|thumb|left|CTA]]


==References==
==References==

Revision as of 16:50, 10 December 2013

Vertebrobasilar insufficiency

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The CT angiography(CTA) shows a high sensitivity and specificity in the diagnosis of VBI.

CT

The normal CT can diagnose subarachnoid hemorrhage following the intracranial vertebral artery dissection, but can't provide enough definition to the artery. The contrast CT (CTA) has high sensitivity (94%) and specificity (95%) to make a correct diagnosis compared against the DSA.[1] And some researchs reveal that the CT-baesd score can be used in predicting the final infarct size[2] and also for a prognostic assesment early ischemic injury in basilar artery occllusion.[2][3][4][5]

CTA

References

  1. ↑ Long A, Lepoutre A, Corbillon E, Branchereau A (2002) review of non- or minimally invasive methods (duplex ultrasonography, MR- and CT-angiography) for evaluating stenosis of the proximal internal carotid artery. Eur J Vasc Endovasc Surg 24 (1):43-52. PMID: 12127847
  2. ↑ 2.0 2.1 Puetz V, Sylaja PN, Hill MD, Coutts SB, Dzialowski I, Becker U et al. (2009) CT angiography source images predict final infarct extent in patients with basilar artery occlusion. AJNR Am J Neuroradiol 30 (10):1877-83. DOI:10.3174/ajnr.A1723 PMID: 19643923
  3. ↑ Cho TH, Nighoghossian N, Tahon F, Némoz C, Hermier M, Salkine F et al. (2009) Brain stem diffusion-weighted imaging lesion score: a potential marker of outcome in acute basilar artery occlusion. AJNR Am J Neuroradiol 30 (1):194-8. DOI:10.3174/ajnr.A1278 PMID: 18768716
  4. ↑ Renard D, Landragin N, Robinson A, Brunel H, Bonafe A, Heroum C et al. (2008) MRI-based score for acute basilar artery thrombosis. Cerebrovasc Dis 25 (6):511-6. DOI:10.1159/000131668 PMID: 18480603
  5. ↑ Terasawa Y, Kimura K, Iguchi Y, Kobayashi K, Aoki J, Shibazaki K et al. (2010) Could clinical diffusion-mismatch determined using DWI ASPECTS predict neurological improvement after thrombolysis before 3 h after acute stroke? J Neurol Neurosurg Psychiatry 81 (8):864-8. DOI:10.1136/jnnp.2009.190140 PMID: 20562433

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