Prevalence study of proximal vertebral artery stenosis using high-resolution contrast-enhanced magnetic resonance angiography.
OBJECTIVE
To evaluate the prevalence of proximal vertebral artery stenosis, compared wiith those of the distal vertebral/basilar artery and extracranial internal carotid artery, in a large population of stroke and non-stroke patients.


METHODS
Nine-hundred-and-thirty-five patients who underwent high-resolution contrast-enhanced magnetic resonance angiography in a regional general hospital were categorized into six groups based on neurological symptoms and disease: an asymptomatic group (n = 182), a minor symptom group with headache or dizziness (n = 519), a cardiac group with coronary artery steno-occlusive disease (n = 15), a hemorrhagic group with old cerebral hemorrhage (n=26), an anterior circulation infarct group (n = 121), and posterior circulation infarct group (n = 72). Prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was analyzed.


RESULTS
The prevalence of stenosis of the proximal vertebral artery, distal vertebral/ basilar artery, and internal carotid artery was 12.9%, 5.5%, and 7.2%, respectively, in the study population, and rose as the age increased (P < 0.0001 for all arteries). The prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was 3.3%, 0.5%, and 1.1%, respectively, in the asymptomatic group; 8.3%, 2.1%, and 3.7%, respectively, in the minor symptom group; 13.3%, 6.7% and 6.7%, respectively, in the cardiac group; 19.2%, 7.7%, and 7.7%, respectively, in the hemorrhagic group; 27.3%, 8.3%, and 25.6%, respectively, in the anterior circulation infarct group; and 44.4%, 36.1%, and 16.7%, respectively, in the posterior circulation infarct group. This increasing tendency of stenosis accordingly was statistically significant (P < 0.0001 for all arteries).


CONCLUSIONS
The prevalence of proximal vertebral artery stenosis was highest, compared with those of the distal vertebral/basilar artery and internal carotid artery, although the clinical significance of proximal vertebral artery stenosis should be investigated in further studies.
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
S H
SH
Kim
J S
JS
Lee
O K
OK
Kwon
M K
MK
Han
J H
JH
Kim
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007723:Korea / Q000453:epidemiology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D020521:Stroke / Q000453:epidemiology; D014711:Vertebral Artery / Q000473:pathology; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000453:epidemiology*
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA