颅内动脉开窗畸形的CT血管成像诊断及其临床意义

Evaluation of intracranial artery fenestration with computed tomography angiography and its clinical significance

目的:探讨多层螺旋CT血管成像(CTA)对颅内动脉开窗畸形的诊断价值。方法:回顾性分析30例颅内动脉开窗畸形的CTA资料,着重探究该畸形的好发部位、CTA特征及其开窗畸形的临床意义。结果:30例颅内动脉开窗畸形(单发28例,双发2例)共发现了32处开窗畸形,位于基底动脉12处,前交通动脉9处,椎动脉颅内段4处、枕骨大孔段1处,大脑前动脉3处(A1段2处、A2段1处),大脑前与前交通动脉复合体2处,大脑后动脉P1段1处。开窗血管分支2条的30处,3条的2处;形态呈裂隙状24处(开窗血管长度≤5 mm),凸透镜状8处(5 mm<开窗血管长度≤12 mm)。1例合并2枚动脉瘤。32处开窗畸形CTA均能从多角度清晰显示它们的位置、形状及其与邻近结构的关系。结论:多层螺旋CTA可无创诊断颅内动脉开窗畸形,了解该畸形可提高经血管颅内动脉介入治疗或头颈联合区手术的成功率。

Objective：To investigate the diagnostic value of CT angiography inevaluating intracranial artery fenestration.Methods：CT angiography images were acquired on 30 patients with intracranial artery fenestration,and the retrospective analysis was performed to evaluate the predilection sites,features,and the clinical significance of intracranial artery fenestration.Results：Thirty-two intracranial fenestration lesions were found in 30 cases（28 of solitary lesion,2 of bilateral lesions）.Among them,12 of the fenestration were located in the basilar artery,9 in anterior communicatingartery,4 in intracranial vertebral artery,1 was in the foramen magnum paragraph,3 were in anterior cerebral artery（2 in A1 segment,1 in A2 segment）,2 were in the complex of anterior cerebral and anterior communicating artery,and 1 was in the P1 segment of posterior cerebral artery.There were 30 cases of fenestration lesions with 2branch vessels,while 2 cases of fenestration lesions with 3 branch vessels.24 of fenestration were crack-like（fenestration vessel length≤5 mm）,while 8 of fenestration were lenticular（5mm 〈 windows vessel length ≤12 mm）.1 case of fenestration was combined with 2 aneurysms.32 fenestration deformities can be observed clearly on CT images for their location,morphology,and the adjacent structures.Conclusion：Multi-slice CT angiography can be used to evaluate intracranial arterial fenestration non-invasively,which will improve the success rate of both interventional therapy and surgery.