Iwasa Naoki, Saito Kozue, Shimada Daisuke, Tanaka Akito, Uchihara Yuto, Ando Takafusa, Sugie Kazuma
Department of Neurology, Nara Medical University, Kashihara, Nara, Japan.
Radiol Case Rep. 2021 Nov 11;17(1):166-170. doi: 10.1016/j.radcr.2021.10.021. eCollection 2022 Jan.
Rotational vertebral artery occlusion is a rare cause of ischemic stroke in the vertebrobasilar arteries. While computed tomography angiography (CTA) is less invasive for the diagnosis of rational vertebral artery occlusion than digital subtraction angiography and more useful for elucidating the correlation between vertebrobasilar arteries and the surrounding structure, carotid ultrasound is noninvasive and more beneficial for the real-time evaluation of the hemodynamic change with neck rotation compared to CTA. Here, we reported 2 cases of rotational vertebral artery occlusion in patients aged 81 and 38 years and proposed a novel technique for its diagnosis using ultrasound-guided CTA. We suggest that the combination of ultrasound and CTA is useful for diagnosing rotational vertebral artery occlusion, which would compensate for the disadvantages of CTA alone.
旋转性椎动脉闭塞是椎基底动脉缺血性卒中的罕见病因。虽然计算机断层血管造影（CTA）在诊断旋转性椎动脉闭塞方面比数字减影血管造影侵入性小，并且在阐明椎基底动脉与周围结构之间的相关性方面更有用，但与CTA相比，颈动脉超声是无创的，并且在评估颈部旋转时血流动力学变化的实时性方面更具优势。在此，我们报告了2例年龄分别为81岁和38岁的旋转性椎动脉闭塞患者，并提出了一种使用超声引导CTA进行诊断的新技术。我们认为超声和CTA联合应用有助于诊断旋转性椎动脉闭塞，这可以弥补单独使用CTA的不足。
