症状性椎基底动脉狭窄或闭塞介入治疗的术前评估

The symptomatic vertebra-basilar arteries stenosis or occlusion: the evaluation of preoperational interventional therapy

目的通过对椎基底动脉狭窄或闭塞患者影像资料的综合分析,探讨介入治疗的适应证。方法23例椎基底动脉狭窄或闭塞患者行MRI、DSA和CTP检查,了解椎基底动脉狭窄或闭塞程度、部位、侧支循环、脑血流灌注等情况,并判断其相关性,筛选介入治疗的适应人群。结果CTP0期与侧支循环1级(r=0.764,P=0.046)和2级(r=0.944,P=0.001)具有很好的相关性;CTPⅠ期与侧支循环0级(r=0.905,P=0.005)和1级(r=0.969,P=0)具有很好的相关性;CTPⅡ期与侧支循环0级(r=0.889,P=0.007)和1级(r=0.923,P=0.003)有很好的相关性;颅外与颅内动脉狭窄程度与CTP分级无统计学意义(P值分别为0.862和0.966)。结论选择椎基底动脉狭窄或闭塞的适应证时要综合分析MRI、DSA和CTP影像资料。

Objective According to the comprehensive preoperative evaluation of imaging information for the patients with vertebrobasilar artery stenosis to choice the indication of intervention. Methods 30 patients with vertebrobasilar artery stenosis were accepted magnetic resonance imaging （MRI）, digital subtraction angiography （DSA） and computed tomography perfusion （CTP） to discuss the relationships of the degree of stenosis, location, collateral circulation and cerebral hemodynamics. Results There were good correlation between grade 0 of CTP and grade 1 or 2 of collateral circulation （r=0. 764, P=0. 046; r=0. 944, P=0. 001）, and good correlation between grade Ⅰ of CTP and grade 0 or 1 of collateral circulation （r=0. 905, P=0. 005; r=0. 969, P=0）, and good correlation between grade Ⅱ of CTP and grade 0 or 1 of circulation （r=0.889, P=0.007; r=0.923, P=0.003）. There was no statistical significance between the stenosis of intracranial or extracranial arteries and grade of CTP. Conclusion In order to guide the clinical diagnosis and therapy and prognosis,we need to undertake the comprehensive analysis of MRI, DSA and CTP for the patients with vertebrobasialr artery stenosis.