椎基底动脉扩张延长症MRI表现及后循环脑梗死危险因素分析

Vertebrobasilar Dolichoectasia:MRI Imaging Features and Risks Assessment of Posterior-circulation Cerebral Infarction

目的通过分析磁共振成像(magnetic resonance imaging,MRI)影像表现探讨椎基底动脉扩张延长症(vertebrobasilar dolichoectasia,VBD)发生椎基底动脉血流淤滞、后循环脑梗死的主要危险因素。方法收集22例符合诊断标准的VBD患者,其中男16例,女6例,年龄39~79(61.70±10.80)岁,在磁共振图像上测量每例VBD患者椎基底动脉最大内径并对基底动脉(basilar artery,BA)进行高度评分与位置评分,采用Mann-Whitney U检验评价上述BA指标与发生椎基底动脉血流淤滞、后循环脑梗死之间的关联性。结果 22例VBD患者中20例有高血压病史,出现陈旧或急性后循环区域脑梗死共8例,BA梭形动脉瘤形成2例,11例在液体衰减反转恢复序列成像(fluid attenuation inversion recovery,FLAIRs)、T1加权成像(T1-weighted imaging,T1 WI)图像上出现椎基底动脉"亮血管"征。"亮血管征"阳性组与阴性组比较,2组间BA位置评分、BA内径差别具有统计学意义(P<0.05),BA总评分具有统计学差异(P<0.01);而后循环脑梗死阳性组与阴性组比较,2组间的BA位置评分、BA总评分均有统计学差异(P<0.05)。结论VBD患者BA位置偏移可能与后循环脑梗死的发生有关。

Objective To explore major factors which caused blood stagnation in vertebrobasilar artery and cerebral infarction in posterior-circulation region of vertebrobasilar dolichoectasia（VBD）through magnetic resonance imaging（MRI）analysis.Methods A total of 22 patients confirmed with VBD were included into this study,there were 16 males and 6 females,the average age was（61.7±10.8）years（rang,39-79 years）.The basilar artery（BA）maximum diameter was measured on MRI images,BA height scores,BA location scores and BA total scores were recorded.The relationship between BA indexes and cerebral infarction were evaluated respectively by Mann-Whitney U test.Results Among 22 patients,20 cases had a history of hypertension,8 cases occurred old or acute infarction in the posterior circulation area,2case were BA fusiform aneurysm,11 cases presented＂bright-blood-vessel sign＂of vertebrobasilar artery on fluid attenuation inversion recovery（FLAIR）,T1-weighted imaging（T1WI）.Between bright-blood-vessel sign positive group and negative group,there were statistically different in BA maximum diameter and BA location scores（P〈0.05）,and significantly different in BA total scores（P〈0.01）.Between posterior circulation cerebral infarction positive group and negative group,there were significantly different in BA location scores and BA total scores（P〈0.05）.Conclusion For patients with VBD,BA position offset probably contribute to the posterior circulation cerebral infarction.