椎基底动脉延长扩张症的CT与临床分析

CT and clinical analysis of the vertebrobasilar dolichoectasia

目的探讨椎基底动脉延长扩张症(VBD)的CT及临床特点,以提高对VBD的认识。方法回顾性分析80例椎基底动脉延长扩张症患者的CT表现及其临床资料,总结其特征。结果 80例均在CT扫描上提示椎基底动脉增粗、扩张、迂曲,测量其宽径大于或等于4.5mm,平均(5.77±0.95)mm,且分叉高于鞍上池或者位置超出鞍背或斜坡范围甚至达第三脑室后方;80例VBD中伴有基底动脉壁钙化55例,脑干局部受压50例,62例合并腔隙性脑梗塞,65例有高血压病史,51例具有眩晕病史,8例伴有不同程度颅神经受压症状,12例无明显症状体征。结论 VBD诊断主要靠影像学,CT可作为一种安全有效的常规诊断手段,充分认识其CT征象及临床表现对提高VBD的诊断准确率颇有意义。

Objective To explore the CT characteristics and clinical manifestations of the vertebrobasilar dolichoectasia （VBD）. Methods CT manifestations and clinical data of 80 cases of patients with VBD were analyzed retrospectively, and its characteristics were summarized. Results The CT images showed that all the 80 patients had significantly thickened, expanded and tortuous vertebrobasilar arteries at the posterior of the third ventricle. These arteries were larger than or equal to 4.5 mm in width, with on average of （5.77±0.95） mm, and branched above the suprasellar cistern or beyond the saddle back or even up to the third veqtricle posterior slope range. Of all the 80 patients, 55 cases were accompanied by the calcification of vertebra basilar artery, and 50 patients＇brainsterns were partially under pressure, 62 patients suffered from lacunar cerebral infarction, 65 patients had past histories with hypertension, 51 patients had past histories with vertigo, 8 cases presented with different degrees of cranial nerve compression symptoms, and 12 cases had no obvious symptoms and signs. Conclusion VBD diagnosis is mainly dependent on iconography, and CT can be used as a safe and effective routine diagwostic methods. To improve the diagnostic accuracy of VBD, it＇s important to understand its CT characteristics and clinical manifestations fully.