A technique for imaging the vertebral artery using pulsed doppler ultrasound

A 30 channel directional pulsed Doppler imaging system (MAVIS) has been used to produce images of the vertebral artery. The technique of imaging the subclavian artery in the suparaclavicular fossa, the origin of the vertebral artery and the section of this vessel up to the foramen in the transverse process of the sixth cervical vertebra is described. Further segments of the vertebral artery appearing between the cervical transverse processes can also be imaged if disease in the mid portion of the vessel is suspected. Confirmation of the identity of the insonated artery is gained from its position on the image in relation to the subclavian and common carotid arteries and from its characteristic flow velocity wave forms. Examples of the typical antero-posterior images obtained are presented. Of 60 vertebral arteries scanned, 56 have been imaged successfully. Insufficient patients have undergone conventional contrast angiography to allow data on diagnostic accuracy but the unsuccessful scans may well have been in those with occluded vessels. Application of the technique to the investigation of patients with either vertebro-basilar symptoms or the subclavian steal syndrome is discussed.