脑动脉DSA形态分析及其意义

DSA analysis of the cerebral arteries and its clinical significance

目的:探讨脑血管造影各主要动脉的投影规律及其分支的显示率,为脑血管疾病的影像诊断和介入治疗提供重要参考。方法:随机抽取140例全脑血管DSA系列图像,选择其中无脑血管疾病的51例进行观察。分别统计颈内动脉和椎动脉造影时正常脑血管各主要分支的显示率;归纳大脑前动脉A1段、大脑中动脉M1段及大脑后动脉P1段在平面上的投影规律并分析总结了脑动脉的正常解剖学特征及其变异。结果:①脑底动脉变异较大;②颈内动脉照影时OA、AChA、ACoA、PCoA、ACA和MCA的显示率分别为96.1%、92.2%、52.9%、69.6%、100%和100%;③椎动脉造影时PICA、AICA、BA、SCA、PCA和PCoA的显示率分别为66.7%、62.7%、100%、70.6%、80.4%和41.2%。结论:①尽管脑底血管实际解剖关系较为复杂,但造影时反映到平面上可简捷的用“水平、上升、下降”等来描述血管的形态和走行;②虽然是平面图像,通过调整投照体位仍可非常逼真的反映血流的动态变化。

Objective: To explore the projective rules of cerebral arteries and the displaying rate of their main branches during cerebral angiographic examination. Methods: 51 cases normal series images were selected from the DSA images of 140 cases of cerebral angiogram randomly. The main revealed branches were analyzed at lateral and anteroposterior projection via ICA and VA. The projective rules of A1 segment, M1 segment and P1 segment were deduced respectively. Their anatomical characteristics and variation were also summarized separately. Results: Variations of the cerebral arteries at the base of the brain were very common. Table 2 and table 3 showed the displaying rate of main vessel branches of ICA and VA. Table 4 showed the projective rules of A1 , M1 and P1 segment on anteroposterior view. Table 5 showed the projective rules of OA, PCoA and AChA on lateral view. Conclusions: Although existing complicated anatomic relation among the vessels on the base of the brain, the courses of them can be described briefly as level, ascending and descending and so on for the DSA images. The hemodynamics of the cerebral arteries can be also reflected on the image vividly by adjusting the projective positions.