后循环供血区缺血性脑卒中患者的椎、基底动脉血管形态改变的影像学分析

The analysis of the morphologic changes of vertebral and basilar artery in patients with posterior circulation ischemia by imaging

目的探讨后循环供血区缺血性脑卒中(PCIS)患者的椎动脉、基底动脉血管形态的影像学改变。方法回顾分析2012年1月~2016年2月136例PCIS患者的MRI、CTA影像学资料,总结该类患者血管形态学改变的影像学特点,同期前循环缺血性脑卒中127例为对照组。结果 (1)PCIS组136例血管形态改变者128例,占94.12%,其中扭曲45例(33.09%),狭窄35例(25.74%),纤细23例(16.91%),闭塞13例(9.56%),异常粗大7例(5.15%);非PCIS组127例,血管形态改变者46例(36.22%),其中狭窄17例,扭曲、纤细等29例;(2)2组血管形态异常发生率比较有明显差异(P<0.01)。结论 PCIS患者椎动脉、基底动脉血管形态存在异常改变。椎、基底动脉扭曲、发育纤细、粗大等和狭窄性病变的血管形态改变可能均为PCIS的重要危险因素之一。

Objective To discuss the morphologic changes of the vertebral and basilar artery in patients with posterior circulation ischemia（ PCIS） by imaging. Methods Retrospective analysis of the MRI,CTA of 136 cases of patients with PCIS from 2012 January-2016 February was performed,summing up the characteristics of the vascular morphological changes through the imaging clinical data. Anterior circulation infarct 127 cases were considered as the control group. Results（ 1） PCIS group of 136 cases,128 cases had vascular morphologic changes,accounted for94. 12%. The artery tortuosity of 45 cases（ 33. 09%）,stenosis in 35 patients（ 25. 74%）,slender in 23 cases（ 16. 91%）,occlusion in 13 cases（ 9. 56%）,7 cases of abnormal large（ 5. 15%）. Of non PCIS group 127 cases,46 had vascular morphological changes（ 36. 22%）. Including stenosis in 17 cases,tortuosity and slender in 29 cases.（ 2）the incidence difference of two groups with vascular abnormality morphological changes was statistically significant（ P〈0. 01）. Conclusion Vertebral artery,basilar artery vascular morphology was associated with PCIS. Vertebral and basilar artery tortuosity,dysplasia,the changes of vascular morphology in large and narrow lesions might be one of the important risk factors of PCIS.