Echographic pattern features of dissections of the extracranial parts of the brachiocephalic arteries

Purpose: to determine the frequency of various ultrasound signs of dissections of the extracranial parts of the brachiocephalic arteries, as well as to compare the results of ultrasound and neuroimaging methods in the diagnostics of dissections.

Materials and methods. The study included data on 108 patients, among them 44 (40.7%) women, 64 (59.3%) men, mean age was 56 ± 14 years. All patients underwent duplex scanning of the brachiocephalic arteries, 53 patients underwent CT-angiography, and 99 patients underwent MRI.

Results. The sensitivity of duplex scanning in the primary diagnosis of dissections in our study was 97.2%. In 40 patients (37%) with dissections according to duplex scanning the presence of dissection was also confirmed on CT-angiography or MRI. Expansion of the vessel diameter and the presence of intramural hematoma (IMH), as well as their combination, were the most common ultrasound signs of dissections in our study. In cases where dissection was not confirmed by CT-angiography or MRI data moderate echogenicity of IMH was noted significantly more often (p = 0.018). Of all the ultrasound signs of dissections, the highest share of coincidence with the signs obtained with neuroimaging diagnostic methods occurred with IMG.

Conclusion. The most frequently recorded ultrasound signs of dissections were the expansion of the vessel diameter and the presence of IMG, as well as their combination. The results of the study showed a high sensitivity of the ultrasound method in detecting dissections, especially in the subacute and chronic stages, as well as to determine the causes of ischemic stroke in the differential diagnosis of brachiocephalic artery pathologies.

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