椎动脉MRA在颈椎病变中的应用

The Application of Vertebral Artery MRA in Cervical Vertebral Destructive Lesion

目的 :探讨椎动脉核磁共振血管成像 (MagneticresonanceangiographyMRA)在颈椎病变中的应用价值。方法 :本组 8例 ,男 5例 ,女 3例。年龄 7～ 42岁 ,平均 2 6岁。病变范围为C1～C6 ,X线片及CT显示椎体均有破坏 ,其中 4例侵犯一侧横突 ,横突孔被包裹在病灶组织内。术后病理证实颈椎结核 4例 ,慢性炎症 1例 ,嗜酸性肉芽肿 2例 ,血管瘤1例。全部患者术前行椎动脉MRA检查 ,观察双侧椎动脉成像及走行。结果 :3例患侧椎动脉发生扭曲并偏移向中线 ,2例椎动脉局部受压 ,3例椎动脉平直行走无扭曲。无 1例椎动脉阻塞、管壁侵蚀、假性动脉瘤形成。结论 :颈椎病变如肿瘤、结核、炎症等常造成椎动脉走行变异 ,前瞻性MRA检查是预防术中椎动脉损伤的有效方法。

Objective:To evaluate the value of vertebral art ery magnetic resonance angiography (MRA) in the cervical vertebral destruction l esion.Methods:There were eight cases,five males and three females.The age were f rom 7 to 42 years averaged 26 years.The lesion involved C_1 to C_6.Vertebr al body was destructed in all cases on plain radiography and CT scan.Four cases had one side transversarium destruction.The lesion were tuberculosis in 4 cases ,osteomyelitis in 1 case,eosinophilic granuloma in 2 cases and angioma in 1 case according to histodiagnosis postoperation.All patients underwent vertebral arte ry MRA preoperatively to detect the course and outline of the vertebral artery. Results:There were no vertebral artery occlusion in all patients.Vertebral arter y was tortuous and displaced medially in 3 cases,local compression in 2 cases,st raight with normal flow in 3 cases.There was no vascular wall erosion or pseudoa neurysm in all cases.Conclusion:The lesion as tumor,tuberculosis,or infection of cervical vertebrae could cause abnormal course of vertebral artery.MRA was the most important prospective detection of this condition to prevent the vertebral artery injury during operation.