椎基底动脉扩张延长症的影像学表现及临床特点(附9例分析)

Imaging analysis and clinical characteristics of vertebrobasilar dolichoectasia( 9 case reports attached)

目的：探讨椎基底动脉扩张延长症（ VBD）的影像学表现及临床特点，进而提高对VBD的认识。方法对9例经CT、MRI确诊的VBD患者影像学及临床资料进行回顾性分析，总结其影像学表现和临床特点。结果9例扩张的椎基底动脉直径为4．8～14．0 mm，迂曲的基底动脉和椎动脉颅内段长度分别为29．8～46．5 mm和23．8～33．4 mm。基底动脉分叉高度及基底动脉侧向偏移度均以2级（ Smoker 分级法）最常见：分别有6例（66．7％）和5例（55.6％）；基底动脉右侧移位7例（77．8％）；基底动脉钙化6例（66．7％）；桥脑受压变形4例（44．4％）。9例中，发现后循环供血区腔隙性脑梗死5例（55．6％），大面积脑梗死1例（11．1％），蛛网膜下腔出血1例（11．1％）。结论VBD是一种少见的脑血管变异性疾病，临床表现多样且不典型，其诊断主要依靠影像学表现，CT、MRI可作为VBD的重要筛查方法。

Objective To discuss the imaging findings and clinical characteristics and improve the understanding of verte -brobasilar dolichoectasia （ VBD） .Methods The imaging and clinical data of 9 VBD patients diagnosed by CT and MRI were analyzed retrospectively to summarize their imaging findings and clinical characteristics .Results The diameter of dilated ver-tebral basal artery in 9 cases ranged from 4.8mm to 14.0mm,and the lengths of intracranial segment of circuitous basal artery and vertebral artery ranged from 29.8mm to 46.5mm,and from 23.8mm to 33.4mm, respectively.The most common degrees of bifurcation height and lateral deviation for basal artery were both grade 2（Smoker grading method）, accounting for 66.7%（6 cases） and 55.6%（5 cases） respectively.Right shift in the basal artery was 7 cases （77.8%）,calcification in the basal artery 6 cases （66.7%） and compression deformation in pons 4 cases （44.4%）.Among the 9 cases of VBD,there were 5 ca-ses of lacunar infarction in posterior cerebral circulation area （55.6%）,1 case of large infarction area（11.1%） and 1 case of subarachnoid hemorrhage （11.1%）.Conclusion VBD is a rare variant of cerebrovascular disease , with various and non-typ-ical clinical manifestations .Its diagnosis mainly depends on imaging findings .CT and MRI can be used as important screening methods of VBD .