Usefulness of 3D-CT Angiography for the Evaluation of Dissecting Aneurysm of the Vertebral Artery

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  • 椎骨動脈解離性動脈瘤における 3D-CT angiographyの有用性

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Dissecting aneurysm of the vertebral artery is difficult to identify, since the typical angiographic finding of double lumen is rarely recognized, and the pearl and string sign is difficult to differentiate from fusiform aneurysm associated with spasm. Moreover, dissecting aneurysm of the vertebral artery undergoes angiographic changes with time, so follow-up examinations should be repeated at frequent intervals. Magnetic resonance angiography can demonstrate narrowing of the arterial lumen and intraluminal hematoma, but cannot accurately visualize arterial narrowing. Recently, three-dimensional computed tomography (3D-CT) angiography has been used for the diagnosis and treatment planning of cerebral aneurysms presenting with or without subarachnoid hemorrhage. Angiography and 3D-CT angiography were used to evaluate 3 cases of dissecting aneurysm of the vertebral artery, 2 presenting with ischemia and 1 with subarachnoid hemorrhage.One case of ischemia showed string sign and the other 2 cases showed pearl and string sign. Follow-up examination by angiography and 3D-CT angiography showed healing had occurred. The view provided by 3D-CT angiography was highly consistent with that of angiography. Therefore, 3D-CT angiography is a useful supplementary examination to angiography.

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