三维螺旋CT血管造影评估椎动脉形态与颈椎骨质增生的价值

Value of the three-dimension spiral computer tomograph angiography in evaluation of the shape of vertebral artery and the cervical spondylotic hyperosteogeny

目的:评估三维螺旋CT血管造影对椎动脉型颈椎病的诊断价值。方法:选择2002-03/2005-06在南京医科大学附属南京第一医院诊治的76例患者,进行三维螺旋CT血管造影检查,观察椎动脉形态及与颈椎骨质增生的关系。结果:76例患者全部完成三维螺旋CT血管造影,其表现有3种:一是骨赘压迫椎动脉;二是椎动脉变细或粗细不均;三是椎动脉迂曲。病因为钩突关节骨赘压迫椎动脉、椎动脉迂曲、椎动脉痉挛、横突孔狭窄、椎动脉局限性狭窄、椎动脉变异、椎动脉牵拉移位,其中钩突关节骨赘压迫椎动脉占42%。最常见的压迫部位是C4～5,C5～6节段,共69例(80%)。结论:三维螺旋CT血管造影能客观地反映椎动脉型颈椎病的病理改变,具有重要的临床价值。

AIM： To study the value of three-dimension spiral computer tomograph angiography （3D-SCTA） in the diagnosis of vertebral cervical spondylotic arteriopathy （CSA）. METHODS： A total of 76 patients clinically diagnosed as CSA in the First Hospital of Nanjing Medical University between March 2002 and June 2005 were selected for 3D-SCTA examinations to observe the shape of vertebral artery and its correlation with CSA. RESULTS： All the 76 patients completed the 3D-SCTA, and suggested 3 kinds of manifestation： compression of vertebral artery by osteophyte; thinning or thickness difference of vertebral artery; and vertebral artery circuity. The pathogeny included uncinate process hyperosteogeny, vertebral artery circuity, vertebral artery spasm, stenosis of transverse foramen, local stenosis of vertebral artery, variation of vertebral artery, shift of vertebral artery, and the compression of vertebral artery by uncinate process osteophyte occupied 42%. The common position of compression appeared in C4-5. C5-6, occupied 80% （69 cases）. CONCLUSION： 3D-SCTA, which can Objectively reflect the pathology of CSA, has important clinical value.