MSCT诊断椎-基底动脉先天变异的价值及临床意义

The value and clinical significance of MSCT in the diagnosis of vertebra basilar artery congenital variation

目的探讨多排螺旋CT血管造影(MSCTA)诊断椎-基底动脉先天变异的价值及临床意义。方法对160例临床表现头痛,头晕为主要症状患者进行128层螺旋CT血管成像检查,应用最大密度投影(MIP),容积再现(VR),多平面重建(MPR)等后处理技术对椎-基底动脉进行观察,分析椎-基底动脉起源、行径、管径、数目、窗式等变异。结果160例患者中,共发现起源变异1例(0.6%),椎动脉颅外段入横突孔变异11例(6.8%),椎动脉颅内段走行迂曲变异74例(46.3%),一侧优势椎动脉变异105例(65.6%),一侧椎动脉缺如变异2例(1.3%),窗式变异5例(3.1%),单干椎动脉形成基底动脉23例(14.4%)。结论 MSCTA血管成像可以清晰、全程、直观、多角度显示椎-基底动脉先天性解剖变异,为椎-基底动脉供血不足病因诊断及椎基底动脉供血不足颈部手术、血管内介入治疗提供解剖学基础。

Objective To study multi-slice spiral CT angiography （MSCTA） manifestations of vertebra-basilar artery congenital variation, and to evaluate the value and clinical significance of MSCTA in the diagnosis of vertebral basilar arter- y congenital variation. Methods 160 eases with headache, dizziness as the main clinical symptoms were examined by 128 slice CT angiography, using reconstructive techniques of multi-slice CT, such as maximum intensity projection （MIP）, volume rendering （VR）, multi planar reconstruction （MPR）. For vertebral basilar artery, we analyzed vertebral basilar artery origin, behavior, diameter, number, window variation. Results In 160 cases, the origin variation was found in 1 ease （0.6%）. Extracranial vertebral artery into the transverse process hole variation was found in 11 cases （6.8%）, in- tracranial vertebral artery running tortuosity variation in 74 cases （46.3 %）, and side dominant vertebral artery variation in 105 cases （65.6%）. There were 2 cases of unilateral absence of vertebral artery number variation （1.3%） and 5 cases of fenestration （3.1%）. Cooperation formed 23 cases of vertebral artery basilar artery （14.4%）. Conclusion 128 slice-spi- ral CT angiography can clearly, fully, intuitively, multi-angle display vertebra- basilar artery congenital variant, there by providing the anatomic basis for vertebra basilar artery insufficiency diagnosis and neck surgery, intravascular intervention- al therapy.