脑血管造影在脑血管病变中的应用价值

The vlue of cerebral angiography in the cerebral vascular diseases

目的：分析脑血管病变在脑血管造影中的影像学表现特点，讨论脑血管造影显示的脑血管形态学改变在探讨脑血管病变的发病机制、预测临床表现及选择治疗方式中的应用价值。方法：回顾性分析2005年1月-2007年10月行脑血管造影检查并明确诊断为脑血管病变的病例140例，观察各种脑血管病变的造影表现，探讨病变血管的形态学特点与脑血管病变的发生、临床过程、治疗方式等的关系。结果：前交通动脉瘤组中，A1优势征26例（占68．42％），随机选取293例非前交通动脉瘤脑血管造影病例作为对照组，A1优势征11例，两组比较差异具有显著性（P〈0．05）。脑动静脉畸形组中单支引流静脉的出血率比3支或以上引流静脉明显升高，两组间差异有显著性（P〈0．05），不同数量供血动脉组中出血率差异未见显著性（P〉0．05）。颈内动脉狭窄或闭塞组中前交通动脉或后交通动脉代偿在单、双侧病变中出现率的比较差异有显著性。结论：A1优势征是前交通动脉瘤发生的高危因素。脑动静脉畸形单支引流静脉的出血率明显高于多支引流静脉，供血动脉的数目则不是脑动静脉畸形出血的相关因素。单侧颈内动脉狭窄或闭塞患者经过前交通动脉或后交通动脉的侧支血流代偿，而双侧颈内动脉狭窄或闭塞患者主要是通过后交通动脉的侧支血流代偿。

Objective：The puprose of our study was to obsevre the cerebarl angiographic fatuers and evaluate the value of cerebarl angiographie investigating the development of ecrbarlvaseular diseases,perdioting the manefistation and chosing theorpy methdos. Methods ：Ceerbarl angiogarphic maniefstations in 140 cases of cerebarlvascular diseases were retrospectively rerviewed in 2005.01--2007.10,all of which had been definietly dignosised as cerebarlvaseular diseases by cerebarl angiogarphy. Results ：A1 dominant signs in aneuyrsms rgoup of the anetior communicating artery was more common than those in the contorl gorup（P〈0. 05）. A1 dominant sign is the related factor of the anetrior communicating artery aneuvsrm SA（CoAA）. No significant difference of the bleeding risk was seen among cebrarl artenovenous malformation（AVM）gorups classified according to the number of feeding arteries （P〉0. 05） ,while the difference of the bleeding risk between one darining vein and more than three darining veins reach statistical significance （P〈0.05）. The ratios of the ACoA and PCoA colateral circutlation in lateral and bilateral ICA stenosis or oceulation. Conclusion： A1 dominant sign is the dangerous factor for anterior communiacting artery aneuyrsm （ACoAA） formation. The number of feeding arteris was not a corralation factor of the cerebarl AVM hemorrhage,while the hemohrfage rate of the cerebral AVM with one darining vein was obviously higher than that of the cerebarl AVM with over three darining veins. Blood supply from basilar artery and those getting blood supply from other artery. Laetarl ICA with setnosis or occulation was chiefly supplied by posterior communicating artery.