环椎椎动脉沟桥与颈性眩晕关系的临床影像研究

Study on the image of vertebral artery ditch bridge of atlas and cervical dizziness

目的探讨环椎椎动脉沟桥与颈性眩晕的关系,提高环椎椎动脉沟桥的认识。方法分析103例环椎椎动脉沟桥X线表现,11例结合脑血管多普勒检查,评价基底动脉供血情况。结果环椎椎动脉沟桥表现为全环型和半环型,后者又分为前半环型、后半环型和双半环型(中间骨性桥板缺如),沟桥可一侧出现,也可双侧出现。全环型沟桥多呈椭圆型,沟桥桥板厚薄不一,密度也可不一致。11例主诉眩晕,照片仅见沟桥存在,而其他未见异常,头颈部前屈、后仰或旋转时,其眩晕症状加重。显示沟桥与眩晕存在密切的关系,沟桥的发生机制应包括环椎解剖变异和环枕韧带钙化或骨化两个方面。结论环椎椎动脉沟桥可以对椎动脉产生压迫,引起供血不足,产生眩晕,应重视环椎椎动脉沟桥的X线诊断。

Objective To explore the relationship between the vertebral artery ditch bridge of atlas and cervical dizziness. Methods The cervical X-ray films of 103 cases of vertebral artery ditch bridge of atlas were analyzed, and 11 cases of those were checked with the basilar artery blood supply on the cerebral vessel by TCD. Results The ditch bridge was divided into two types： the complete and incomplete type, the latter could be subdivided into forward half ring form, backward half ring form and double half ring form （no middle-bone bridge plate）. The ditch bridge was observed one side or two sides, most of the complete types were elliptical, the bone bridge plate could not correspond with the thickness and density. The 11 cases showed no abnormal signs of the cervical spine, except the ditch bridge and dizziness. When the head was flexed ventrally, extended dorsally or rotated, the dizziness became worsened. It was closely related to the ditch bridge and cervical dizziness, and the mechanism included congenital malformation and calcinosis or ossification of atlantooccipital ligament. Conclusions The vertebral artery catch bridge of atlas can oppress vertebral artery and make vertebrobasilar insufficiency, so the ditch bridge should be noticed in X-ray diagnosis.