Ultrasonography in diagnosis and monitoring of dissection of cervicocerebral arteries
Introduction. Ultrasonography has become part of the arsenal of diagnostic methods available for examining the dissection of cerebral blood vessels (DCV). Aims. To analyse the value of ultrasonography in the diagnosis and monitoring of DCV. Patients and methods. We conducted a consecutive study of 6...
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2004
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| Acceso en línea: | https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_02100010_v38_n9_p813_LagosGrinstein http://hdl.handle.net/20.500.12110/paper_02100010_v38_n9_p813_LagosGrinstein |
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| Sumario: | Introduction. Ultrasonography has become part of the arsenal of diagnostic methods available for examining the dissection of cerebral blood vessels (DCV). Aims. To analyse the value of ultrasonography in the diagnosis and monitoring of DCV. Patients and methods. We conducted a consecutive study of 67 patients with a history and clinical manifestations compatible with DCV; all of them were given confirmation of their diagnosis by another reference method (digital angiography or MR angiography) during the 48 hours prior to or following the ultrasound study. The ultrasonography was carried out on the neck and skull as per the usual system using continuous Doppler, neck duplex and transcranial Doppler ultrasonography. Ultrasound diagnosis of the dissection was based on direct and indirect signs, in the absence of an atheroma plaque. The following were considered to be direct signs: haematoma in the wall of the vessel, flap, local increase in flow velocity and echograms with split systole. Indirect signs were: haemodynamic alterations proximal to the dissection, a pattern of slow flow and high resistance. Transcranial Doppler showed the findings lying distal to the dissection to be a lowered mean velocity and pulsatility. Results. The ultrasonography of the series revealed direct signs in 46 patients (69%) and indirect signs in 21 (31%). Ultrasonography was used as the primary diagnostic method in 29 (43%) patients; in the other 38 (57%) it was employed to verify the diagnosis or for the follow-up. All the ultrasound diagnoses were confirmed using digital angiography (21 cases) or magnetic resonance angiography (46 cases). Conclusions. Due to its harmlessness, ultrasonography may be the first examination used to establish a probable diagnosis of DVC. |
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