Three-Dimensional Digital Subtraction Angiography in Evaluation of Vertebro-Basilar Artery Dissections: Comparison with 2D DSA

BACKGROUND AND PURPOSE The purpose of this study was to clarify characteristic findings on three-dimensional (3D) digital subtraction angiography (DSA), and to investigate diagnostic usefulness of 3D DSA in vertebro-basilar dissections (VBD). METHODS In 25 consecutive patients with VBD, two-dimensional (2D) DSA, and 3D DSA findings were evaluated by a scoring system. The effects of 3D DSA results on diagnosis were scored in comparison with 2D DSA results. RESULTS A proximal stenosis, a distal stenosis, a bleb, and a relationship between the posterior inferior cerebellar artery and the dissection were significantly better visualized in 3D DSA than those in 2D DSA (P < .05). A characteristic finding of VBD on 3D DSA was a combination of an aneurysmal bulging and its proximal and distal stenoses, which was observed in 92% of the 25 patients. CONCLUSIONS Three-dimensional DSA was more useful for diagnosis in patients with VBD in comparison with 2D DSA.