椎基底动脉扩张延长症中的CT与MRI表现

Performance of CT and MRI in vertebrobasilar dolichoectasia

目的:探讨椎基底动脉扩张延长症(VBD)的CT及MRI表现特征。方法:回顾性分析2016年1月至12月江苏省丰县人民医院影像学诊断的28例VBD患者的临床和影像学资料。所有患者均有1.5T MRI及MRA资料,16例有多层螺旋CT资料[其中4例有多层CT血管造影(CTA)资料]。重点分析MRA/CTA显示的VBD异常血管的分布、形态大小、信号强度等。结果:CT平扫11例显示基底动脉增粗、迂曲,4例基底动脉壁可见钙化。MRI所有序列均可见基底动脉增粗、迂曲。CTA及MRA可直观、多角度全程显示椎基底动脉的扩张、延长或迂曲,本组扩张基底动脉直径为4.8~13.5 mm,长度为30.2~34.0 mm,MRI及MRA很好显示了邻近脑干受压、脑神经受累及可能伴发的脑梗死等病变。结论:CT及MRI平扫可作为VBD筛查的主要影像学检查方法,MRA及CTA可全面直观评价VBD,值得应用。

Objective： To explore the performance of CT and MRI in evaluating vertebrobasilar dolichoectasia（ VBD）. Methods： Fom January 2016 to December 2016,28 patients with VBD were diagnosed by imaging in People＇s Hospital of Fengxian. The clinical and imaging data were retrospectively analyzed. All patients underwent 1.5 T MRI and MRA examination,and 16 patients also underwent multislice CT examination[4 cases of them underwent multi-slice CT angiography（ CTA） examination]. The distribution,shape size,and signal intensity of VBD abnormal blood vessels on the MRA and CTA imagings were analyzed. Results： Plain CT scan showed dilated and tortuous basilar arteries in 11 cases as well as basilar artery wall calcification in 4 cases. The dilated and tortuous basilar arteries were seen in all MRI sequences. CTA and MRA displayed the expansion,extension or tortuosity of the vertebraobasilar in a clear and multi-perspective way throught the examination. The basilar artery diameter was 4.8 to 13.5 mm,and length of the basilar artery was 30.2 to 34.0 mm.MRI and MRA also satisfactorily showed the compression of adjacent brain stem and cranial nerve as well as the possible cerebral infarction and other diseases. Conclusion： Plain CT scan and plain MRI scan can be used as the main imaging methods for VBD screening. MRA and CTA can evaluate VBD comprehensively in a visualized way,and were worthy of application.