后交通动脉容积CT数字减影血管成像研究

The study of posterior communicating artery on volume computed tomography digital subtraction angiography

目的运用容积CT数字减影血管成像(volume CT digital subtraction angiography,VCTDSA)对后交通动脉(posterior communicating artery,PCoA)进行形态学研究。方法收集我院在2016年3月至12月期间行头颈血管VCTDSA检查158例被检者,并行VR、slab MIP图像后处理。观察158例(316侧)被检者PCoA的变异、走形、有无漏斗样膨大,测量PCoA直径、基底动脉(basal artery,BA)直径、漏斗直径、PCoA发出角度。结果 (1)PCoA变异和走形:缺如52.8%,发育不良8.9%、胚胎型17.1%、成人型21.2%。PCoA弯曲64.5%、平直35.5%。胚胎型更多呈平直,成人型更多呈弯曲(χ~2=7.5,P=0.006)。(2)PCoA直径和发出角度男女、左右均未见统计学差异。总平均BA直径与总平均PCoA直径呈明显负相关,(r=-0.998,P=0.000)。(3)漏斗发生率为26%(32/121),漏斗组与非漏斗组间的PCoA变异(χ~2=10.2,P=0.001)、PCoA直径(t=-5.7,P=0.000)及发出角度(t=-3.2,P=0.002)有统计学差异。结论 (1)PCoA直径和BA直径呈明显负相关。(2)成人型、直径更小、发出角度越小的PCoA越容易发生漏斗。

Objective To study the morphology of the posterior communicating artery（PCoA） on volume CT digital subtraction angiography（VCTDSA）. Methods VCTDSA scans from 158 cases（316 sides） were performed, and then the images of PCoA were reconstructed by VR and slab MIP. The variation,appearance, infundibular dilatation（ID） of the PCoA were observed. The diameters of PCoA, basal artery（BA）and ID, and the proximal inflow angle of PCoA were Measured. Results（1） PCoA variation and appearance： absent 52.8%,dysplasia 8.9%, Fetal type 17.1%,Adult type 21.2%,bend 64.5%, straight 35.5%.Fetal type-PCoA is more straight,Adult type-PCoA is more bend（χ^2=7.5,P=0.006）.（2） PCoA diameter and the proximal inflow angle had no statistical difference between men and women, so were they between right and left. The correlation between PCoA and BA diameter had remarkably statistical significance（r=-0.998,P=0.000）.（3） The incidence of PCoA-ID was 26%（32/121）. The variation of PCoA（χ^2=10.2, P=0.001）, the diameter（t=-5.7, P=0.000）, and proximal inflow angle of PCoA（t=-3.2, P=0.002） between the ID group and non-ID group had statistical difference. Conclusions（1） The diameter of PCoA is negatively correlated with the diameter of BA;（2） The incidence of PCoA-ID is higher in adult type PCoA, or in PCoA with smaller diameter or smaller inflow angle.