椎动脉三维CT血管成像对椎动脉型颈椎病的诊断价值

3D-CT vertebral artery angiography for cervical spondylotic vertebral arteriopathy

目的:探讨椎动脉三维CT血管成像(CTA)在椎动脉型颈椎病(CSA)诊断中的应用价值。方法:2007年7月～2008年4月临床上诊断为CSA的患者共21例(CSA组),对其CTA上显示的椎动脉、横突孔及钩椎关节增生情况进行观测,并与21例非CSA患者(对照组)的CTA观测结果进行比较分析。结果:CSA组中椎动脉正常者4例,管腔变细者7例,走行异常者1例,椎动脉硬化者2例,管腔局限性狭窄者4例,血管走行迂曲者3例,无血管闭塞的患者。对照组中14例椎动脉表现正常,管腔变细者4例,走行迂曲者3例。两组中血管正常、局限性狭窄出现比率间均有显著性差异(P<0.05,χ2分别为9.72、1.21)。CSA组中11例(52.4%)患者共有36个钩椎关节增生,以C4～C7增生(28个,77.8%)最为常见,32个(88.9%)为轻度增生,3个(8.3%)为中度增生,1个(2.8%)为重度增生。对照组中,6例(28.6%)患者共有19个钩椎关节增生,只有1个(5.3%)表现为中度增生,其余均为轻度增生。结论:CTA可以较好地显示椎动脉异常、局限性狭窄及钩椎关节的增生情况,在CSA中具有一定的诊断价值。

Objective：To evaluate the application value of vertebral artery three-dimensional CT angiography（CTA） on patients with cervical spondylotic vertebral arteriopathy（CSA）.Method：21 patients with CSA（CSA group） from July 2007 to April 2008 were reviewed retrospectively.The abnormalities of vertebral artery,transverse foramen,and hyperplasy of Luschka joint were visualized on CTA,and then contrast analysis of 21 patients with no vertebral arterial insufficiency（control group） were performed.Result：Among 21 cases with CSA,vertebral artery angiography showed normal in 4 cases,vertebral artery narrow in 7 cases,course abnormity in 1 cases,arteriosclerosis in 2 cases,local stenosis of vertebral artery in 4 cases,vertebral artery circuity in 3 cases and no obstruction.For control group,vertebral artery angiography showed normal in 14 cases,vertebral artery narrow in 4 cases,and vertebral artery circuit in 3 cases.There was statistically significant difference between two groups in vertebral artery normal and local stenosis（P0.05,χ2 were 9.72 and 1.21,respectively）.A total of 36 cervical Luschka joints were evidenced osteosis in different degree in 11（52.4%） CSA patients which appeared mostly between C4 and C7（28 joints）,32（88.9%） of Luschka joints had slightly osteosis,3（8.3%） had moderate and 1（2.8%） had severity osteosis.For control group,19 cervical Luschka joints had osteophyte in different degree in 6（28.6%） patients.Only 1（5.3%） of hyperplasia Luschka joint had moderate osteophyte,and the others had slightly osteophyte.Conclusion：Vertebral artery abnormality as well as the osteophyte of Luschka joint can be shown in CTA,which approve the diagnostic value of cervical spondylotic vertebral arteriopathy.