椎动脉狭窄及阻塞的磁共振血管造影相关影像学研究

The imaging research about stenosis and occlusion of vertebral artery in MRA

目的 探讨磁共振血管造影（MRA）技术对椎动脉狭窄和阻塞的实际应用价值.方法 对97例就诊于吉林大学第一医院椎动脉狭窄和阻塞患者的脑动脉MRA图像进行处理,并对椎动脉和相关脑梗死的影像学数据进行测量.结果 研究和统计了椎动脉狭窄和阻塞的位置、斑块性质以及与其相关脑梗死位置和体积.发现非优势动脉的狭窄发病率明显高于优势动脉,其中椎动脉起始端的发病率最高,达到52.3％,但严重程度与发病部位没有明显的相关性.对斑块性质的分析发现,纤维性、钙化性和混合性斑块比例较为接近,而脂类斑块较少.与狭窄相对应的梗死灶在颅内分布以大脑和脑干为主,小脑仅为12.1％,且狭窄程度与梗死体积呈正相关.结论 MRA可清晰地显示椎动脉狭窄和阻塞的位置,判断其狭窄严重程度和斑块性质,并可预计与椎动脉相关的脑梗死的风险和严重程度.

Objective To discuss the actual application value of magnetic resonance angiography technol- ogy in vertebral artery stenosis and occlusion. Methods The vertebral artery MRA image of 97 patients who see doctor in the first hospital of Jilin university were analyze and the parameters of the vertebral artery and cerebral infarction which relate with the stenosis and occlusion of vertebral artery were measured. Results The location of the stenosis and obstruction in vertebral artery, the nature of the plaque, as well as the location and volume of the related cerebral infarction were measured. The results showed that the incidence in unpreponderant arteries was significantly higher than which in preponderant arteries, and the initial segment of vertebral artery has the highest incidence, achieving about 52.3%. But the severity has no concern with the pathogenic site. In the analyze to the nature of plaque, fibroid plaque, Calcified plaque and mixed plaque had a similar proportion, and fatty plaque was the least proportion. The infarcts which correspond to stenosis mainly distributed in brain and brain stem, only about 12.1% which was in cerebellum. In addition the degree of stcnosis and the volume of infarction were posi- tively correlated. Conclusion MRA can clearly show the location of the stenosis and obstruction in vertebral artery, judge the severity and nature of the plaque and expect the risk and severity of cerebral infarction which re- late with the stenosis and occlusion of vertebral artery.