椎动脉供血不足的MRI诊断

MRI Dagnosis of Vertebral Artery Insufficiency

目的:分析椎动脉供血不足的各种MRI征象,探讨其临床价值。材料与方法:收集临床拟诊椎动脉供血不足而行MRI检查的患者86例,进行MRI检查,对其MRI及CEMRA重建图像进行分析,对椎动脉的MRA评价主要包括其血管形态的观察以及周围组织结构改变。结果:椎动脉可见多段发病或多种病变形态共存的特点,椎动脉形态异常主要为先天发育畸形,包括管腔纤细,双侧椎动脉变细,单侧椎动脉变细以及椎动脉走行变异。血管局部狭窄,包括椎动脉起始段狭窄;颈椎段狭窄,包括椎间盘压迫、钩突关节增生压迫、横突孔增生;椎动脉颅内段扭曲狭窄等。结论:MRI尤其是MRA技术可以简便、直观显示椎动脉以及全面多方位观察它的形态,在一定程度上能够为临床准确诊断椎动脉供血不足提供直接证据。

Purpose： To analyze the various MRI signs, investigating their clinical value. Materials and Methods： 86 cases suspected to have vertebral artery insufficiency were tested by MRI; their MRI and CEMRA reconstruction images were analyzed. The assessment of vertebral artery was mainly focused on the observation of its vascular morphology and structural changes of its surrounding tissues. Results： Analysis showed that multilevel involvements and various pathologies both exist in the vertebral artery. Vertebral artery morphological abnormalities were mostly congenital malformations, including spinal stenos, bilateral vertebral artery thinning, unilateral vertebral artery thinning, and vertebral artery course variation, arterial stenosis, including stenosls at the beginning segment of vertebral artery, vertebral stenosls, including compression of protruded cervical intervertebral disc, compression of apophyseal joints proliferations, transverse foramen hyperplasia and intracranial vertebral artery tortuous stenosis. Conclusion： MRI , especially MRA, can conveniently and objectively show vertebral artery and give it a full, muhi-faceted observation. To a certain degree, it can provide direct evidences for accurate clinical diagnosis of vertebral artery insufficiency.