64层螺旋CT血管成像对椎基底动脉先天性变异的诊断价值

Diagnostic value of 64-slice spiral computed tomography angiography in studying variation of vertebrobasilar artery congenital

【目的】采用64层螺旋CT血管成像对椎基底动脉供血不足患者进行研究,探讨椎基底动脉先天性变异对椎基底动脉供血不足患者的诊断价值。【方法】对693例临床诊断或拟诊为椎基底动脉供血不足的患者(病例组)和51例无临床症状的健康体检者(对照组)行头颈部64层螺旋CT血管成像检查。应用容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)和高级血管分析(AVA)等后处理技术对椎基底动脉进行观察,统计分析椎基底动脉发生起源、路径、数目、窗式等变异的部位及数量。【结果】病例组693例患者成功获得1386根椎动脉:47例(6.8%)起源异常;112例(16.2%)路径变异;1例(0.1%)右侧双椎动脉;38例(5.5%)有窗式变异;62例(8.9%)一侧椎动脉发育不良,未汇入基底动脉,对侧直接延续为基底动脉。对照组健康体检者51例,成功获得102根椎动脉:1例(2.0%)起源异常;5例(9.8%)路径变异;51例(100.0%)双侧椎动脉正常汇合成基底动脉。【结论】64层螺旋CT血管成像能够清晰的显示椎基底动脉的解剖变异,在研究椎基底动脉先天性变异对椎基底动脉供血不足患者发病的影响中有重要的临床意义。

【Objective】To study the diagnostic value of congenital variation of vertebrobasilar artery in patients with vertebrobasilar insufficiency（VBI） by 64-slice spiral computed tomography angiography（64-slice CTA）.【Methods】A total of 693 patients diagnosed or suspected as vertebrobasilar insufficiency（case group） and 51 healthy people without VBI symptoms and CTA negative（control group） were examined by 64-slice CTA.The image data of vertebrobasilar artery were postprocessed by use of volume rendering（VR）,maximum intensity projection（MIP）,multiple planar reformation（MPR）,curved planar reformation（CPR） and advanced vessel analysis（AVA） to display the variation of vertebrobasilar artery： origin,path variation,duplication and fenestration.【Results】1 386 vertebral arteries in 693 patients with vertebrobasilar insufficiency were successfully displayed.Of the 693 patients,47 cases（6.8%） with unusual origin;112 cases（16.2%） with path variation;1 case（0.1%） with duplication;38 cases（5.5%） with fenestration;62 cases（8.9%） with vertebral artery hypogenesis that didn’t come into basilar artery.102 vertebral arteries in control group were successfully displayed.Of the 51 patients,1 cases（2.0%） with unusual origin.5 cases（9.8%） with path variation.51 cases（100.0%） with normal bilateral vertebral artery forming basilar artery.More variations were displayed in patients with vertebrobasilar insufficiency than those of in control.【Conclusion】64-slice spiral CT angiography can clearly display the anatomical variation and play an important role in studying the influence of vertebrobasilar artery congenital variation to the patients with vertebrobasilar insufficiency.