64排螺旋CT血管成像诊断椎动脉成窗变异

Diagnosis of Vertebral Artery Fenestration by 64 Slices Spiral CT Angiography

目的分析椎动脉成窗变异的CT血管成像(CTA)表现,提高对该血管变异的认识。资料与方法回顾性分析37例经64排螺旋CTA诊断为椎动脉成窗变异患者的影像学资料,分析椎动脉成窗的部位、形态、与周围血管及骨质的关系等特征及其合并症。结果 2051例行头颈64排CTA检查的患者中发现椎动脉成窗变异37例(1.8%),其中颅内型19例,颅外型16例,颅内-外型2例。颅外型中,6例发生于寰椎段;2例成窗的"窗径"<2mm,呈孔状;35例较大者中,15例成窗的分支粗细不等,呈"OK手势征",20例病变分支粗细基本一致,呈部分重复走行。1例伴其他血管动脉瘤,2例伴大脑前动脉成窗。结论 64排CTA能快速、直观、准确地诊断椎动脉成窗变异及其合并症,熟悉椎动脉成窗的CTA特征有助于指导临床制定合理的治疗方案,提高相应治疗中的安全性。

Objective To analyze the CT angiographic features of basilar artery fenestrations in an effort to improve recognition of this anomaly. Materials and Methods The imaging data of 37 patients with basilar artery fenestrations were evaluated retrospectively. The fenestration＇s incidence,location,configuration and relationship between the anomaly and surrounding structures were analyzed. The coexisting abnormalities were also evaluated. Results Among the 2051 patients＇head and carotid CTA images,37 fenestrations of vertebral artery（1.8%） were found,which 19 fenestrations were at the intracranial level,16 fenestrations were at extracranial level,and 2 fenestrations located at atlantoaxial level and the intracranial segment of the artery. 2 small fenestrations （less than 2 mm） presented foramen-like.15 of 35 larger fenestrations simulated an ＂ok＂ hand sign,and 20 fenestrations showed partial duplication type of fenestration.1 case coexisted with aneurysm of other artery. 2 patients were associated with anterior cerebral artery fenestrations. Conclusion 64-slices CTA is a rapid,intuitive,and accurate method for demonstrating vertebral artery fenestration and its coexisting abnormalities,and may be helpful for procedures choice and decreasing the risk of operation.