基于头颈部CT动脉成像的永存原始三叉动脉分型

Classification of Persistent Primitive Trigeminal Artery Based on Cerebral and Carotid CT Angiograph

目的利用头颈部CT动脉成像方法探讨永存原始三叉动脉(PPTA)的科学分型方法及其临床意义。方法回顾性分析经头颈部CT动脉成像检查诊断为PPTA的25例患者的图像,依据Weon法和Salas法将其分型,并对PPTA合并基底动脉发育不良的程度进行分级。结果 25例PPTA,左侧13例,右侧12例。起源于颈内动脉海绵窦段(C4段)24例,1例起源于颈内动脉终末段(C1段)。起源于颈内动脉C4段的24例中,依据Salas法分型,外侧型23例,中间型1例;依据Weon法分型,1型11例,2型3例,3型5例,4型3例,5型2例。PPTA合并基底动脉发育不良的分级为0度5例,1度6例,2度4例,3度7例,4度3例。结论 PPTA的Weon分型和Salas分型辅以基底动脉发育不良程度分级能够更加全面地涵盖PPTA的各种解剖特点,准确地评价PPTA的各种变异,清晰地揭示临床症状和外科手术风险,具有临床推广应用价值。

Objective To explore a scientific classification of persistent primitive trigeminal artery（PPTA） based on CT angiography and to review its clinical significance.Methods Images obtained by cerebral and carotid CT angiography performed between January 2013 and June 2015 were analyzed for the presence of a PPTA.According to Weon et al.＇s and Salas et al.＇s proposal,we classified each PPTA by the two different methods.Besides,each PPTA was graded based on the degree of vertebral basilar artery hypoplasia.Results Of all 25 patients with a PPTA,thirteen PPTAs were located on the left side,and twelve PPTAs on the right side.24 PPTAs originated from the cavernous segment（C4） of the ICA,and1 PPTA originated from the terminal segment（C1） of the ICA.Among the former 24 PPTAs,according to the classification of Salas et al.＇s proposal,23 PPTAs were a lateral type,and one was a medial type.According to the classification of Weon et al.＇s proposal,eleven were classified as type 1,three as type 2,five as type 3,and three as type 4,and two as type 5.As for the grades of basilar artery hypoplasia,five were graded as 0 degree,six as 1 degree,four as 2 degree,seven as 3degree,three as 4 degree.Conclusion The Weon et al.＇s and Salas et al.＇s classifications assisted by the degree of basilar artery hypoplasia can fully cover various anatomical features of PPTA,accurately evaluate the various variations of PPTA and clearly disclose some symptoms and surgical risk.So it is recommended to be used in clinical application.