椎-基底动脉病变引起脑干形态及位置变化的3.0 T MRI研究

3.0 T MRI Research of the Shape and Location of the Brainstem Caused by Vertebrobasilar Artery Abnormality

目的探讨椎-基底动脉病变与脑干形态及位置之间的关系。资料与方法2006年10月至2007年7月经临床及MRA或CTA检查发现有椎-基底动脉血管异常218例及正常对照组218名,常规行MRI及MRA检查。观察并记录脑实质MRI表现分型、颅内椎-基底动脉形态位置分级、血管与脑干的关系、脑干有无旋转,对资料进行统计学分析。结果病例组椎动脉越过中线及基底动脉移位数量均高于对照组,两者间差异有统计学意义(右椎动脉:χ2=60.398,P<0.05;左椎动脉:χ2=54.461,P<0.05;基底动脉:χ2=205.007,P<0.05)。病例组脑干与血管接触高于对照组,两者间差异有统计学意义(χ2=26.037,P<0.05)。对照组脑干未见旋转,病例组103例患者脑干发生旋转,椎动脉是否越过中线与脑干旋转之间有关系(χ2=19.467,P<0.05)且关系密切(C=0.89),椎动脉粗细与脑干旋转之间有关系(χ2=19.357,P<0.05)且关系密切(C=0.76)。结论应用先进的MRI技术对椎-基底动脉病变进行分析、研究,能够准确真实地显示血管移位、脑干变形旋转等形态学上的改变,为诊断和进行针对性治疗提供重要的依据。

Objective To investigate the relationship between vertebrobasilar artery abnormality and the shape and lo- cation of the brainstem. Materials and Methods Clinical, conventional MRI and MRA or CTA data were collected from 218 consecutive patients with vertebrobasilar arteries abnormality from October 2006 to July 2007- 218 healthy people were taken as control. The MRI appearance,the course of vertebrobasilar artery and the position of the brainstem were recorded. The results were analyzed statistically. Results The number of vertebrobasilar artery which crossed the midline in the test group was more than that in control group,there was significant difference between the two groups （right vertebral artery：X2 = 60. 398 ,P 〈 0.05 ; left vertebral artery＇： X2 = 54. 461, P 〈 0.05 ; basilar artery ： X2 = 205. 007, P 〈 0.05 ）. The oppres- sion of brainstem by the vertebrobasilar artery in the test group was more common than that in control group,there was sig- nificant difference between the two groups （ X2 = 26. 037, P 〈 0.05 ） , there was no brainstem rotation in the control group, the number of the brainstem rotation in the test group wasl07. Whether the vertebral artery crossed the median line had close re- lationship with the brainstem rotation （ ~2 = 19. 467, P = 0. 000, C = 0.89 ）. The diameter of the vertebral artery had close re- lationship with the brainstem rotation（ x2 = 19. 357 ,P = 0. 000, C = 0.76）. Conclusion 3.0T MRI and MRA or CTA can reveal the vertebrobasilar artery abnormality,the deformity and rotation of the brainstem,which provide important evidence for the diagnosis and treatment.