MRI/MRA, DSA, and duplex sonographic findings in 19 patients with extracranial VADs
| Patient No | VAD | Delay (days)2-150 | MRI | MRA | DSA | Duplex | MRA follow up (delay) |
|---|---|---|---|---|---|---|---|
| 1 | L | 6 | Mural haematoma V3 | Stenosis V3-4 | String sign V3 | HRS | Pseudoenlargment2-160 (14 days), recanalisation (12 months) |
| 2 | R | — | — | String sign V3 | — | Recanalisation (3 months) | |
| 3 | L | < 1 | Mural haematoma V3, luminal thrombis V4 | Stenosis V3 | String sign V3, occlusion V4 | HRS | Occlusion (> 12 months) |
| 4 | L | 7 | Normal V3-4 | Normal V2-4 | Intimal flap V1 | Normal | Normal (12 months) |
| 5 | L | < 1 | Luminal thrombus V4 | Occlusion V1, V4, stenosis V2-3 | Occlusion VA L | HRS | Recanalisation (2 weeks) |
| 6 | R, L | 14 | Luminal thrombus BA | Stenosis V3-4 R, L, occlusion. BA (delay to DSA 14 day) | Double lumen V1 L, string sign V2-4 R, occlusion BA | No flow L, R | — |
| 7 | L | 5 | Luminal thrombus V3-4 | Stenosis V2, occlusion V3-4 | — | HRS | Recanalisation (> 12 months) |
| 8 | R | 3 | Luminal thrombus V4 | Stenosis V3, occlusion V4 | — | HRS | Recanalisation (8 months) |
| 9 | R | < 1 | Luminal thrombus V3-4 | Stenosis V2, occlusion V3-4 | String sign V2-3, occlusion V4 | HRS | Recanalisation (3 months) |
| 10 | R | 3 | Luminal thrombus V4 | Stenosis V2-3, occlusion V4 | — | HRS | Occlusion (> 12 months) |
| 11 | L | — | — | Intimal flap V2, dissecting aneurysm V2 | Normal | Occlusion (9 months after ligation) | |
| 12 | L | < 1 | Luminal thrombus V3-4 | Double lumen V2, occlusion V3-4 | String sign V2, occlusion V3-4 (delay to MRA 1 day) | HRS | Recanalisation (9 months) |
| 13 | R | 5 | Luminal thrombus V3-4 | Occlusion V3-4 | Stenosis V4 | HRS | Recanalisation (12 months) |
| 14 | L | 7 | Luminal thrombus V3-4 | Stenosis V2, occlusion V3-4 | Occlusion V3-4 L | HRS | Recanalisation (> 12 months) |
| 15 | R | 7 | Luminal thrombus V3-4 | Occlusion V2-4 | Intimal flap V1, occlusion V2-4 | No flow | Occlusion (> 12 months) |
| 16 | R | — | — | Intimal flap V1, dissecting aneurysm V1 | Normal | Occlusion (5 months after ligation) | |
| 17 | L | 7 | Mural haematoma V3, luminal thrombus V4 | Stenosis V3, occlusion V4 | String sign V3, occlusion V4 | HRS | — |
| 18 | R | 5 | Luminal thrombus V3-4 | Occlusion V3-4 | String sign V3, occlusion V4 | HRS | — |
| 19 | L | < 1 | Mural haematoma V3 | Stenosis V3, dissecting aneurysm V3 | String sign V3, dissecting aneurysm V3 | Normal | Dissecting aneurysm (2 weeks) |
↵2-150 Delay = interval from neurological deficit to magnetic resonance examination.
↵2-160 Pseudoenlargement = on projections the dissected vertebral artery appears wider than the patent lumen on cross sections.
MRI = magnetic resonance imaging; MRA = magnetic resonance angiography; DSA = digital subtraction angiography; Duplex = B-mode and Doppler sonography; VAD = vertebral artery dissection; delay = interval from neurological deficit to magnetic resonance examination; HRS = high resistance signal; string sign = irregular stenosis; L = left; R = right; V1-4 = vertebral artery segment; BA = basilar artery.