George Joseph T, Bathla Girish, Mark Ian T
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Radiol Case Rep. 2025 Apr 19;20(7):3376-3379. doi: 10.1016/j.radcr.2025.03.041. eCollection 2025 Jul.
Differentiating vertebral artery dissection (VAD) from vertebral artery hypoplasia (VAH) can be difficult with standard CT/CTA imaging. However, making this distinction is critical to providing appropriate patient management. In this brief report/technical note, we describe a new 3D CTA postprocessing technique to potentially distinguish VAD from VAH. We describe a case of right-sided VAD, where the initially rendered 3D images demonstrated a small inner lumen of the vertebral artery (VA). With this technique, VAD and VAH can potentially be conflated as the inner lumens in both conditions are narrow. A subsequent set of 3D images highlighted the outer lumen, which was relatively preserved - a finding in VAD but not VAH. With the proliferation of CTA imaging in the emergency setting, this 3D post processing technique can serve as an invaluable tool. Moreover, this technique offers the potential to be expanded and improved upon by utilizing deep learning (DL)-based segmentation.
使用标准CT/CTA成像很难区分椎动脉夹层（VAD）和椎动脉发育不全（VAH）。然而，做出这种区分对于提供适当的患者管理至关重要。在本简短报告/技术说明中，我们描述了一种新的3D CTA后处理技术，以潜在地区分VAD和VAH。我们描述了一例右侧VAD病例，最初生成的3D图像显示椎动脉（VA）的内腔较小。使用这种技术，VAD和VAH可能会被混淆，因为两种情况下的内腔都很窄。随后的一组3D图像突出了相对保留的外腔——这是VAD的表现而非VAH。随着CTA成像在急诊环境中的普及，这种3D后处理技术可成为一项非常有价值的工具。此外，通过利用基于深度学习（DL）的分割技术，该技术还有扩展和改进的潜力。
