基底动脉迂曲的3.0T MRI血流动力学研究

Hemodynamics quantitative analysis of tortuous basilar artery by 3.0T MRI

目的探讨基底动脉迂曲时基底动脉血流动力学情况。方法选择经临床及MRI检查诊断为基底动脉走行迂曲患者36例(病例组),其中男性26例,女性10例;年龄25~82岁,平均年龄52.11岁。主要表现为头痛、头晕及肢体麻木等。健康志愿者36例(对照组),其中男性22例,女性14例;年龄25~69岁,平均年龄50.36岁。行颅脑磁共振动脉血管成像(MRA)检查,采用快速电影相位对比(Fast CINE PC)及流动敏感交互式反转恢复(FAIR)序列,测量基底动脉中段流速及后循环脑组织血流灌注值,对结果进行统计学分析。结果病例组基底动脉平均流速(23.13±6.90)cm/s,峰值流速(32.85±10.19)cm/s,对照组基底动脉平均流速(31.82±6.39)cm/s,峰值流速(44.63±8.50)cm/s。病例组脑血管平均流速、峰值流速及血流量均比对照组低,差异具有统计学意义(P<0.05)。病例组延髓(105.46±7.16)、脑桥(109.60±5.95)、小脑(119.46±9.92)、枕叶(111.17±7.56)血流灌注值与对照组相比,差异均无统计学意义(P>0.05)。结论基底动脉迂曲可以引起血管内流速及流量的降低,但其供血区脑组织血流量无明显改变。

Objective To investigate the hemodynamics of basilar artery at basilar artery tortuosity. Methods A total of 36 tortuous basilar artery patients mainly with headache, dizziness and limb numbness were enrolled（case group, included 26 males and 10 females, aged 25 - 82 years old with mean age of 52.11 years old）. The 36 healthy volunteers were selected as control group, which included 22 males and 14 females, aged 25 - 69 years old with mean age of 50.36 years old. All of them were examined by magnetic resonance angiography（MRA）, fast CINE phase contrast（Fast CINE PC） and flow-sensitive alternating inversion recovery（FAIR）. The basilar artery flow velocity and posterior circulation of perfusion values were measured and statistical calculated. Results In case group, the mean basilar artery flow velocity and peak velocity were （23.13 ±6.90） em/s and （32.85 ±10.19） em/s. In control group, the mean velocity and peak velocity were （31.82 ±6.39） cm/s and （44.63 ± 8.50） cm/s. The mean flow velocity, peak velocity and blood flow volume of basilar artery in case group were lower than those in control group, the difference was statistically significant（P 〈 0.05）. There was no difference in FAIR value of medulla oblongata（105.46 ± 7.16）, pons（109.60 ± 5.95）, cerebellum（119.46 ± 9.92）, occipital lobe（111.17 ± 7.56） between 2 groups（P 〉 0.05）. Conclusion It is demonstrated that the flow velocity and blood flow volume of basilar artery on patient with tortuous basilar artery decreased, but perfusion of posterior circulation without obvious change.