多排螺旋CTA在颈段脊髓前根动脉损伤中的临床应用

Clinical Application of Multi-detector Spiral CT Angiography in Cervical Anterior Radicular Artery Injury

目的评价多排螺旋CT血管造影(CTA)在颈段脊髓前根动脉(ARA)损伤中的临床应用价值。方法对20例临床怀疑脊髓型颈椎病和颈椎外伤的CTA资料进行分析,观察ARA的损伤情况,以临床怀疑脑供血不足行颈部CTA检查的30例性别和年龄相匹配的患者为对照,观察ARA的走行及显影情况。结果 30例对照中有25例可见ARA显示,数量为1～3支不等,分别经左右椎间孔向前汇入脊髓前动脉。其来源主要为双侧椎动脉,部分来自颈升动脉,少部分源自颈深动脉。20例患者中,13例可见ARA损伤,其中,椎间盘突出7例,表现为突出的椎间盘推挤、压迫ARA;骨质增生2例,表现为增生骨质致相应椎间孔变窄,前根动脉走行路径狭窄,ARA受压;4例为颈椎骨折,骨折片移位压迫ARA,表现为ARA移位、狭窄或中断。结论多排螺旋CTA能较准确的显示颈段脊髓ARA的解剖及走行,对怀疑颈髓缺血的患者应注意了解ARA的损伤情况。

Objective To evaluate the clinical application value of multi-detector spiral computer tomography angiography（CTA） in cervical anterior radicular artery（ARA）.Methods The injuries of ARA of 20 patients with suspected cervical myelopathy and cervical trauma were analyzed.30 patients who were sex and age matched and taken cervical CTA because of the clinical suspected cerebral circulation insufficiency were used as control and the development of images of CTA were observed.Results Anterior radicular arteries of 25 cases were showed in the control group.1 to 3 anterior radicular arteries could be seen,and they passed left and right intervertebral foramen respectively and joined to anterior spinal artery.Their origins were bilateral vertebral arteries mostly,ascending cervical arteries partly,and only a small part came from deep cervical arteries.In the 20 patients,ARA injuries of 13 cases could be seen.7 cases showed disk prolapse and the slipped disk pushed and pressed ATA;2 cases showed hyperosteogeny,and the hyperplastic sclerotin narrowed the corresponding intervertebral foramen,and anterior radicular arteries were compressed.4 cases showed cervical spine fracture and bone fragment pressed ATA,and ATA showed displacement,stenosis and break.Conclusion Multi-detector CTA can display the ARA reliably.More attentions should be paid to ARA injuries of patients with suspected cervical cord ischemia.