Diagnostic value and clinical significance of color Doppler ultrasound in duplication of vertebral artery

doi:10.3877/cma.j.issn.1674-0785.2021.05.005

Abstract

Abstract:

Objective

To explore the diagnostic value and clinical significance of color Doppler ultrasound in duplication of vertebral artery.

Methods

From January 2020 to January 2021 a total of 1139 patients in Beijing Chaoyang Hospital, Capital Medical University suspected of cervical spondylosis of vertebral artery type underwent color Doppler ultrasound examination of the cervical artery were selected. Color Doppler ultrasound was used to detect the cervical blood vessels. The starting position of the vertebral artery, the course, the position of entering transverse foramen, the inner diameter of each segment, the blood flow velocity and the spectrum morphology were observed, then measured and recorded.

Results

(1) Among 1139 patients suspected of cervical spondylosis of vertebral artery type, 9 cases (0.79%) were found with duplication of vertebral artery. (2) There were 4 cases of duplication of vertebral artery on the left. The medial limbs were all from the aortic arch, and the lateral limbs were all from the left subclavian artery. 2 cases were combined at the C4 level, and 2 cases were combined at the C5. There were 5 cases of duplication of vertebral artery on the right. There were 4 cases of medial limbs from right subclavian artery, 1 case from right common carotid artery, 5 cases of lateral limbs were all from right subclavian artery, 3 cases were combined at the C4 level, and 2 cases were combined at the C5. (3) In 4 cases of left duplication of vertebral artery, the inner diameter of the medial limb was larger than that of the lateral limb. In 5 cases of right duplication of vertebral artery, the inner diameter of the medial limb was smaller than that of the lateral limb in only 1 case, and the inner diameter of the medial limb was larger than that of the lateral limb in the other 4 cases. (4) The peak velocity at the beginning of the medial limb was higher than that of the lateral limb, and the peak velocity before the confusion of medial limb was higher than that of the lateral limb.

Conclusion

Color Doppler ultrasound can clearly diagnose duplication of vertebral artery and obtain hemodynamic information, which has high application value and clinical significance.

Key words: Color Doppler ultrasound, Duplication of vertebral artery, Vertebral artery variation, Hemodynamics

Pu Zhang, Ruijun Guo. Diagnostic value and clinical significance of color Doppler ultrasound in duplication of vertebral artery[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(05): 341-346.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2021.05.005

https://zhlcyszz.cma-cmc.com.cn/EN/Y2021/V15/I05/341

Figures/Tables 12

References 15

1	Satti SR, Cerniglia CA, Koenigsberg RA. Cervical vertebral artery variations: an anatomic study [J]. Am J Neuroradiol, 2007, 28(5): 976-980.
2	Thomas AJ, Germanwala AV, Vora N, et al. Dual origin extracranial vertebral artery: case report and embryology [J]. J Neuroimaging, 2008, 18(2): 173-176.
3	Kendi AT, Brace JR. Vertebral artery duplication and aneurysms: 64 slice multidetector CT findings [J]. Br J Radiol, 2009, 82(983): e216-e218.
4	Koenigsberg RA, Pereira L, Nair B, et al. Unusual vertebral artery origins: examples and related pathology [J]. Catheter Cardiovasc Interv, 2003, 59(2): 244-250.
5	Melki E, Nasser G, Vandendries C, et al. Congenital vertebral duplication: a predisposing risk factor for dissection [J]. J Neurol Sci, 2012, 314(1-2): 161-162.
6	Ionete C, Omojola MF. MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: Unusual course and review of the literature [J]. Am J Neuroradiol, 2006, 27(6): 1304-1306.
7	Mordasisni P, Schmidt F, Schroth G, et al. Asymmetrical bilateral duplication of the extracranial vertebral arteries: Report of a unique case [J]. Eur J Radiol Extra, 2008, 67(3): e91-e94.
8	Polguj M, Jędrzejewski K, Topol M, et al. Duplication of left vertebral artery in a patient with dissection of the right internal carotid artery and EhlersDanlos syndrome: case report and review of the literature [J]. Anat Sci Int, 2013, 88(2): 109-114.
9	Takasato Y, Hayashi H, Kobayashi T, et al. Duplicated origin of right vertebral artery with rudimentary and accessory left vertebral arteries [J]. Neuroradiology, 1992, 34(4): 287-289.
10	Jung S, Jung C, Bae YJ, et al. Duplicated origin of the left vertebral artery: a case report and embryological review [J]. Neurointervention, 2016, 11(1): 50-54.
11	Goddard AJ, Annesley-Williams D, Guthrie JA, et al. Duplication of the vertebral artery: report of two cases and review of the literature [J]. Neuroradiology, 2001, 43(6): 477-480.
12	Vasovic´ LP. Reevaluation of the morphological parameters according to 11 different duplications of the fetal vertebral artery at prevertebral (V1) and intracranial (V4) parts [J]. Cells Tissues Organs, 2004, 176(4): 195-204.
13	Chaturvedi S, Lukovits TG, Chen W, et al. Ischemia in the territory of a hypoplastic vertebrobasilar system [J]. Neurology, 1999, 52(5): 980-983.
14	Amazaki M, Koda M, Aramomai MA, et al. Anombous vertebral artery at the extraosseous and intraosseous regions of the cranio vertebral junction:Analysis by three-dimensional computed tomography angiography [J]. Spine, 2005, 30(21): 2452-2457.
15	Gaskill SJ, Heinz ER, Kandt R, et al. Bilateral congenital anomalies of the extracranial vertebral artery: management with balloon therapy [J]. Pediatr Neurosurg, 1996, 25(3): 147-150.

编号	性别	年龄（岁）	发生变异侧	内侧支					外侧支					汇合后
编号	性别	年龄（岁）	发生变异侧	起源	汇合水平	内径（mm）	起始处PSV （cm/s）	汇合前PSV （cm/s）	起源	进入椎间隙的水平	内径（mm）	起始处PSV （cm/s）	汇合前PSV（cm/s）	内径（mm）	PSV （cm/s）
1	女	50	左	Aortic arch	C5	2.4	83	61	LSCA	C6	1.9	66	45	3.4	58
2	女	55	左	Aortic arch	C4	2.7	88	67	LSCA	C6	1.8	65	49	3.1	68
3	男	49	左	Aortic arch	C5	2.5	87	65	LSCA	C6	1.5	57	48	2.9	66
4	女	46	左	Aortic arch	C4	2.6	75	55	LSCA	C6	1.9	60	48	3.0	61
5	女	63	右	RSCA	C4	3.1	82	58	RSCA	C6	1.9	79	42	3.2	59
6	男	56	右	RSCA	C5	2.0	68	50	RSCA	C6	2.2	59	48	3.1	58
7	男	46	右	RSCA	C5	2.5	83	66	RSCA	C6	1.8	63	45	3.0	69
8	女	49	右	RSCA	C4	3.0	79	62	RSCA	C6	1.6	59	46	3.2	65
9	男	54	右	RCCA	C4	2.2	68	53	RSCA	C6	2.0	84	47	3.2	56

编号	性别	年龄（岁）	发生变异侧	内侧支					外侧支					汇合后
编号	性别	年龄（岁）	发生变异侧	起源	汇合水平	内径（mm）	起始处PSV （cm/s）	汇合前PSV （cm/s）	起源	进入椎间隙的水平	内径（mm）	起始处PSV （cm/s）	汇合前PSV（cm/s）	内径（mm）	PSV （cm/s）
1	女	50	左	Aortic arch	C5	2.4	83	61	LSCA	C6	1.9	66	45	3.4	58
2	女	55	左	Aortic arch	C4	2.7	88	67	LSCA	C6	1.8	65	49	3.1	68
3	男	49	左	Aortic arch	C5	2.5	87	65	LSCA	C6	1.5	57	48	2.9	66
4	女	46	左	Aortic arch	C4	2.6	75	55	LSCA	C6	1.9	60	48	3.0	61
5	女	63	右	RSCA	C4	3.1	82	58	RSCA	C6	1.9	79	42	3.2	59
6	男	56	右	RSCA	C5	2.0	68	50	RSCA	C6	2.2	59	48	3.1	58
7	男	46	右	RSCA	C5	2.5	83	66	RSCA	C6	1.8	63	45	3.0	69
8	女	49	右	RSCA	C4	3.0	79	62	RSCA	C6	1.6	59	46	3.2	65
9	男	54	右	RCCA	C4	2.2	68	53	RSCA	C6	2.0	84	47	3.2	56

[1]	Shujie Wei, Pinjing Hui, Yafang Ding, Bai Zhang, Yanhong Yan, Peng Zhou, Yabo Huang. Evaluation of cerebral hemodynamics in patients with unilateral internal carotid artery occlusion undergoing superficial temporal artery-middle cerebral artery bypass [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1046-1055.
[2]	Xiaoyu Li, Qing Jiang, Haiqin Tang, Jingzhi Luo. Clinical study of perioperative comprehensive management in ERCP +LC treatment of patients with choledocholithiasis complicated with acute cholangitis [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 57-60.
[3]	Fengyi Li, Ruofan Li, Xu Gao, Chaofan Zhang. Effect of target-directed liquid intervention on postoperative hemodynamics and gastrointestinal function recovery in elderly patients with gastrointestinal tumors [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 29-32.
[4]	Xinlan Wu, Jing Yu. Application value of color Doppler ultrasound in the differential diagnosis of indirect inguinal hernia, direct hernia and femoral hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(05): 611-614.
[5]	Hongjiang Zhang, Xuelian Liu, Li Zheng. Effect of Alfentanil combined with Propofol anesthesia in laparoscopic high ligation of hernia sac in children [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 711-715.
[6]	Ying Wang, Yiheng Xue, Guoqin Liu. Methodology exploration of the reconstruction mechanisms of blood flow in descengding and sigmoid colon after high ligation of the IMA [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(04): 265-271.
[7]	Zhuanyun Cui, Liping Lv, Dong Chang. Role of color Doppler ultrasound guidance in establishing vascular access for hemodialysis in patients with chronic renal failure [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(04): 205-209.
[8]	Bin He, Jing Wang. Diagnostic value of blood flow parameters, serum uric acid and CysC by color Doppler ultrasound in carotid artery stenosis of transient ischemic attack [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(05): 289-294.
[9]	Jing Wang, Bin He. Prediction effect of transcranial color Doppler ultrasound combined with blood sCD40L, Fib and PAF on cerebral infarction after transient ischemic attack [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(04): 222-227.
[10]	Shanshan Wang, Xiaoru Xu, Zhenxian Shi, Dejie Zhang. Effect of salvianolic acid combined with urinary kallidinogenase on cognitive function, cerebral hemodynamics and serum LPA, ox-LDL, MMP-9 levels in patients with acute cerebral watershed infarction [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(03): 142-149.
[11]	Tianli Li, Zhaolong Zhang, Chengjian Sun, Guoping Liu, Yixing Xie, Xiaolong Zhao, Liming Shao, Xuan Zheng, Changxin Wang, Rui Xu. Study on the risk of ophthalmic artery segment aneurysm rupture based on hemodynamics, blood lipid and peripheral inflammatory indexes [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(02): 78-83.
[12]	Xiaoqin Chen, Xingjiang Li, Tao Hu, Jinyi Zhao, Peiyuan Xue, Wei Liu, Chong Wang, Mingcheng Hu. Computational hydrodynamic analysis of vertebrobasilar tortuous dilatation [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(01): 21-25.
[13]	Yanxia Lin, Caibiao Wu, Xiaoxia Wang. Diagnostic value of real-time contrast-enhanced ultrasound quantitative analysis in focal lesions initially discovered in physical examination [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(02): 176-181.
[14]	Hongyan Tang, Haijun Dan, Zhihong Gao, Zuoyang Zhang, Shumei Zhai, Shaoyu Wu, Yu Zhang. Specificity and sensitivity of cardiac color Doppler ultrasound in clinical diagnosis of patients with chronic heart failure [J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(07): 676-679.
[15]	Yanxu Wang, Yigang He, Yonglin Qin. The application progress of 4D flow MRI in computational fluid dynamics studies of Stanford B aortic dissection [J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2023, 11(02): 159-163.

Please choose a citation manager

Content to export