Clinical Study and Comparison of Magnetic Resonance Angiography (MRA) and Angiography Diagnosis of Blunt Vertebral Artery Injury

Ren, Xiubao; Wang, Weidong; Zhang, Xia; Pu, Yu; Jiang, Tao; Li, Changqing

doi:10.1097/ta.0b013e31815bd78d

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Friedman et al [8] first described magnetic resonance angiography (MRA) as an imaging modality to detect vertebral artery injuries. Ren et al [12] confirmed the accuracy of MRA but noted it may lack the ability to identify small intimal tears. More recently, computed tomography angiography (CTA) has been shown to be a highly sensitive and specific modality for diagnosis of vertebral artery pathology in the setting of acute cervical spine trauma as well as chronic vertebral artery pathology [13][14][15].…”

Section: Historical Reviewmentioning

confidence: 99%

Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction

2013

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Section: Historical Reviewmentioning

confidence: 99%

Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction

2013

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“…Other imaging examinations such as ultrasound, MRI, conventional angiography or DSA have some defections or shortcomings; they cannot show both CJVA and C 0-1-2 on an image [12][13][14]. 3DCTA can clearly and directly show not only the anatomy and variations of VA but also its wall calcification and other pathological changes.…”

Section: Application Of Imaging Anatomymentioning

confidence: 99%

Imaging anatomy and variation of vertebral artery and bone structure at craniocervical junction

Duan

et al. 2009

Eur Spine J

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The objective of this article is to display the vertebral artery and bone structure at the craniocervical junction (CJVA and C(0-1-2)) with three-dimensional CT angiography (3DCTA) and identify their anatomic features and variations. Eighty-eight subjects without pathology of vertebral artery (VA) and C(0-1-2) were selected from head-neck CTA examination. 3D images were formed with volume rendering (VR) and multiplanar reconstruction (MPR). On the 3D images, CJVA and C(0-1-2) were measured, and their variations were observed. CJVA goes along C(0-1-2) with five curves, of which three curves are visibly away from C(0-1-2), one is 0.0-8.3 mm away at the second curve with 0.0-11.2 mm in width, another is 0.0-9.2 mm away at the fourth with 2.8-14.8 mm and the other is 0.0-6.2 mm away at the fifth. Statistical comparisons show that there is no significant difference in the measurements between left and right, and that the curves become smaller and farther away from C(0-1-2) with the increase of age. CJVA is not equal in size, with the biggest in the fourth curve and the smallest in the fifth. Statistical comparison shows the left CJVA is larger than the right in the fifth curve. Variations were found on CJVA in 16 cases and on C(1) in 12 cases. The anatomy and variations of CJVA and C(0-1-2) are complicated. It is of vital significance to identify their anatomic features in clinical practice.

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“…DSA can reveal the alterations of intimal consistency and remains the gold standard of detecting VAI but CTA has demonstrated adequate screening and follow-up accuracy, cost and time effectiveness and similar patient outcomes [1,2,[8][9][10]23]. CTA can also be more easily incorporated to emergency room protocols [24], while MRA constitutes a non-invasive and non-ionizing alternative, that has been found in animal models comparable to DSA as a modality of imaging for VAI [25].…”

Section: Discussionmentioning

confidence: 99%

Implications of Vertebral Artery Blunt Injury to Cervical Spine Trauma Treatment: Short Narrative Review of the Literature Based on Four Cases

2021

J Neurol Exp Neurosci

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Background: Vertebral injury after blunt cerebrovascular injury remains an underdiagnosed clinical entity. Its relatively indolent course may not raise physicians' suspicions and inadequate screening may be used. Even in cases, whereby it is confirmed with an angiographic examination, further dilemmas ensue regarding the administration of antithrombotic medication and the period of time when trauma treatment should take place.Case Series: Herewith, we report of four patients who were treated in our clinic. Two of them suffered a subluxation warranting surgical reduction and anterior stabilization with plate and screws preceded by low-molecular-weight heparin administration. Both of them had intact motoric function of their upper extremities. The other two patients required no surgical procedure for their trauma and antithrombotic treatment initiated after completion of digital subtraction angiography. Conclusions:We support that a scheduled operation should not dissuade surgeons from administrating antithrombotic treatment. A definite operative treatment for underlying cervical spine trauma should be delayed until high risk period for stroke has passed, if no severe neurological deficit exists. Computed tomography angiography is an adequate, time and cost-effective method for VAI screening and diagnosis. As long as, no strong recommendations exist multicenter prospective trials have to be conducted.

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Clinical Study and Comparison of Magnetic Resonance Angiography (MRA) and Angiography Diagnosis of Blunt Vertebral Artery Injury

Abstract: 2D TOF MRA is an effective detection method of blunt vertebral artery injury but it might not be able to differentiate spasm, a small disruption of intima, from others under certain conditions.

Cited by 9 publications

References 11 publications

Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction

Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction

Imaging anatomy and variation of vertebral artery and bone structure at craniocervical junction

Implications of Vertebral Artery Blunt Injury to Cervical Spine Trauma Treatment: Short Narrative Review of the Literature Based on Four Cases

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