Magnetic resonance angiography and transcranial Doppler ultrasound findings in patients with a clinical diagnosis of vertebrobasilar insufficiency

Authors

  • Arlindo Cardoso Lima Neto Universidade de Sao Paulo, Faculdade de Medicina https://orcid.org/0000-0001-5626-0766
  • Edson Bor-Seng-Shu Universidade de Sao Paulo, Faculdade de Medicina
  • Marcelo de Lima Oliveira Universidade de Sao Paulo, Faculdade de Medicina
  • Alberto Macedo Soares Centro Universitario Lusiada
  • Flávia Renata Topciu Centro Universitario Sao Camilo
  • Roseli Saraiva Moreira Bittar Universidade de Sao Paulo, Faculdade de Medicina

DOI:

https://doi.org/10.6061/clinics/2020/e1212

Keywords:

Vascular Vertigo, Arteriography, Transcranial Doppler Ultrasound, Magnetic Resonance Angiography, Diagnosis, Vertebrobasilar Insufficiency

Abstract

OBJECTIVE: To evaluate the findings of magnetic resonance angiography (MRA) and transcranial Doppler ultrasound (TCD) in patients with a clinical diagnosis of vertebrobasilar insufficiency (VBI). METHOD: From our outpatient neurotology clinic, we selected patients (using the criteria proposed by Grad and Baloh) with a clinical diagnosis of VBI. We excluded patients with any definite cause for vestibular symptoms, a noncontrolled metabolic disease or any contraindication to MRA or TCD. The patients in the study group were sex- and age-matched with subjects who did not have vestibular symptoms (control group). Our final group of patients included 24 patients (study, n=12; control, n=12). RESULTS: The MRA results did not demonstrate significant differences in the findings between our study and control groups. TCD demonstrated that the systolic pulse velocity of the right middle cerebral artery, end diastolic velocity of the basilar artery, pulsatility index (PI) of the left middle cerebral artery, PI of the right middle cerebral artery, and PI of the basilar artery were significantly higher in the study group than in the control group, suggesting abnormalities affecting the microcirculation of patients with a clinical diagnosis of VBI compared with controls. CONCLUSION: MRA failed to reveal abnormalities in patients with a clinical diagnosis of VBI compared with controls. The PI of the basilar artery, measured using TCD, demonstrated high sensitivity (91%) and specificity (91%) for detecting clinically diagnosed VBI.

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Published

2020-01-20

How to Cite

Lima Neto, A. C., Bor-Seng-Shu, E., Oliveira, M. de L., Soares, A. M., Topciu, F. R., & Bittar, R. S. M. (2020). Magnetic resonance angiography and transcranial Doppler ultrasound findings in patients with a clinical diagnosis of vertebrobasilar insufficiency. Clinics, 75, e1212. https://doi.org/10.6061/clinics/2020/e1212

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Original Articles