椎基底动脉延长扩张症的CT诊断(附19例报告)

CT diagnosis of vertebrobasilar dolichoectasia. report of 19 cases

目的探讨CT对椎基底动脉延长扩张症的诊断价值。方法前瞻性分析了19例椎基底动脉延长扩张症(VBD)患者的临床资料及其CT表现。结果19例均在5mm薄层CT扫描上显示椎基底动脉增粗、扩张、迂曲,测量其宽径大于等于4.5mm,且分叉高于鞍上池或者位置超出鞍背或斜坡范围。VBD伴有基底动脉壁钙化9例,脑干局部受压10例,基底池扩大4例。大部分合并脑干、小脑、基底节及其他部位梗死、出血。其临床主要表现椎基底动脉供血不足及脑内缺血梗死症状,表现复杂且差异较大。结论VBD诊断主要靠影像学,CT可作为一种安全有效的常规诊断手段,充分认识其CT征象对提高VBD的诊断准确率颇有意义。

Objective To explore the value of CT scans for diagnosing vertebrobasilar dolichoectasia （VBD）. Methods The clinical data and CT findings of 19 patients with VBD were prospectively analyzed. Results On axial thin section （5 mm） images, all the 19 patients had significantly thickened, ectatic and tortous vertebrobasilar arteries whose diameters were larger than or equal to 4.5 mm and partial bifurcations were higher than the suprasellar cistern or the locations were beyond the range of sellar dorsum or clivus. Among 19 cases, VBD associated with calcification of basilar artery walls was found in 9, compression of brain stems in 10, and enlargement of basal cistern in 4. Most patients complicated with infarctions and hemorrhage of brain stem, cerebellum, basal ganglion and other locations. The clinical manifestations of VBD were complex and varied, which mainly appeared as vertebrobasilar artery hypovascularity and intracephalic-ischemic and infarcted symptoms. Conclusion The diagnosis of VBD mainly depends upon imaging techniques in which CT can be taken as one of safe and effective means. Sufficiently understanding CT signs of VBD is very important to elevate the diagnosticaccuracy.