脑干异常旋转的3.0T MRI研究

Research of abnormally rotated brainstem with 3.0T MRI

目的应用3.0T MRI探讨脑干异常旋转的原因及脑干旋转的临床意义。方法2006年10月至2007年8月经MRI检查有脑干异常旋转患者及正常志愿者各103例,常规行MRI及MRA检查。观察并记录脑实质MRI表现、颅内椎-基底动脉位置、脑干旋转程度、脑室系统有无扩张。对资料进行统计学分析。结果对照组未见脑干旋转。延髓旋转的发生率明显高于脑桥旋转。椎动脉是否越过中线与脑干旋转之间有关系(χ2=51.709,P=0.000)且关系密切(相关系数r=0.98)。椎动脉粗细与脑干旋转间有关系(χ2=22.117,P=0.000)且关系密切(相关系数r=0.93)。随着脑干旋转程度的加重,患者临床表现亦加重,且症状更复杂。结论血管的增粗扭曲延长是脑干旋转的重要原因之一,脑干的旋转可能会引起某些脑神经疾患。

Objective To investigate the reason and clinical symptoms of the abnormally rotated brainstem by 3.0T MRI. Methods Clinical, conventional MRI, and MRA datas were collected from 103 consecutive patients with abnormality rotated brainstem on MRI between October 2006 and August 2007. The appearance of MRI, the course of vertebro-basilar artery, the degree of the rotated brainstem, and the dilation of the ventricular system were recorded. The results were analyzed statistically. Results There is no abnormally rotated brainstem in the control group. The number of the abnormally rotated medulla oblongata is more than abnormally rotated pons. Whether the vertebral artery acrossing the median line had close relationship with the abnormally rotated brainstem （X^2= 51. 709, P= 0. 000, correlation coefficient r= 0.98）, the diameter of the vertebral artery had close relationship with the abnormally rotated brainstem （X^2 = 22. 117, P= 0. 000, correlation coefficient r= 0.93）. The larger the degree of the abnormally rotated brainstem, the heavier the clinical symptoms, and the more complicated clinical symptoms. Conclusion Tortuose and coarse vertebro-basilar artery is one of the most important reasons of the rotated brainstem, and the abnormally rotated brainstem may provoke some brain symptoms.