Brunner-Beeg F, von Reutern G M
Asklepios Neurologische Klinik Bad Salzhausen.
Ultraschall Med. 1999 Jun;20(3):83-6. doi: 10.1055/s-1999-14241.
Transcranial colour-coded duplex sonography allows differentiation of both vertebral arteries and the proximal basilar artery by transoccipital insonation. However, imaging is often incomplete. Therefore the aim of this study was to show to what extent imaging of vertebrobasilar arteries can be improved with the use of the echosignal enhancing agent Levovist (LV) in normal subjects without vascular abnormalities or occlusive disease.
In 30 subjects extracranial Doppler and duplex sonography has been used to exclude hypoplasia and proximal or distal obstructions of the vertebral arteries. The intracranial vertebral arteries and the basilar artery were then examined before and after fractionated injection of LV (300 mg/ml, 4 g) by means of colour-coded transoccipital duplex sonography including videorecording.
Without LV only 17 of 90 possible segments could be imaged completely (basilar artery and both vertebral arteries in 30 subjects). After LV 72 of 90 possible segments could be demonstrated. The confluence of the vertebral arteries could be localised in 22 of 30 subjects by means of LV. The average depth was 6.7 cm (5.5 to 8 cm). Additionally branches of the main arterial trunks could be imaged. The basilar artery could be followed up to a depth of 10 cm. In most cases the distal part of the basilar artery could not be evaluated not even by means of LV enhancement.
Imaging of the vertebrobasilar arteries including the proximal basilar artery could be definitely improved by means of echosignal enhancing Levovist. Imaging of the distal basilar artery was not satisfactory. The confluence of the vertebral arteries could not be precisely localised in all cases due to the course of the arteries.
经颅彩色编码双功超声检查可通过经枕骨探测来区分椎动脉和基底动脉近端。然而，成像往往不完整。因此，本研究的目的是表明，在无血管异常或闭塞性疾病的正常受试者中，使用回声信号增强剂声诺维（LV）能在多大程度上改善椎基底动脉的成像。
对30名受试者进行颅外多普勒和双功超声检查，以排除椎动脉发育不全及近端或远端阻塞。然后，通过彩色编码经枕骨双功超声检查（包括视频记录），在分次注射LV（300mg/ml，4g）前后对颅内椎动脉和基底动脉进行检查。
不使用LV时，90个可能的节段中只有17个能完全成像（30名受试者的基底动脉和双侧椎动脉）。使用LV后，90个可能的节段中有72个能被显示。通过LV可在30名受试者中的22名中定位椎动脉汇合处。平均深度为6.7cm（5.5至8cm）。此外，主要动脉干的分支也能成像。基底动脉可追踪至10cm深度。在大多数情况下，即使使用LV增强，基底动脉远端部分也无法评估。
使用回声信号增强剂声诺维可明显改善包括基底动脉近端在内的椎基底动脉成像。基底动脉远端成像效果不理想。由于动脉走行，并非所有情况下都能精确定位椎动脉汇合处。
