椎基底动脉扩张延长症的CT诊断

CT Diagnosis of Vertebrobasilar Dolichoectasia

目的:探讨椎基底动脉扩张延长症(VBD)的CT表现和诊断。方法:收集2011年5月～2015年10月期间淮安市第三人民医院收治的44例经行头颅CT及部分行CTA检查符合椎基底动脉扩张延长症相关影像学诊断标准的VBD患者,排除基底动脉或(和)椎动脉明显狭窄或闭塞、合并动脉瘤者、颅后窝肿瘤者、动静脉畸形以及头部手术史者,进行回顾性分析。结果:44例患者基底动脉或椎动脉直径4.9～10mm,平均(7.67±3.62)mm;基底动脉上端断面:呈圆形29例,呈条形15例;病灶密度均匀30例,边缘斑状钙化4例。44例患者均可见脑萎缩,合并单纯梗死12例,合并梗死及出血3例,合并脑积水4例;基底动脉高度评分2分32例(72.73%),评分3分12例(27.27%),两者差异显著(P <0.05);位置评分2分者33例(75.00%),3分者11例(25.00%),两者差异显著(P <0.05)。结论:椎基底动脉扩张延长症的CT表现存在一定特征性,需结合增强扫描提高诊断准确性。

Purpose: To explore the CT findings of vertebrobasilar dolichoectasia(VBD). Methods: Forty-four cases of VBD who were diagnosed by brain CT and CTA in Huai’an NO.3 People’s Hospital during May 2011 to October 2015 were retrospectively analyzed. They were all excluded of significantly narrow or occlusion of basilar artery or(and) vertebral artery and combined with aneurysms, posterior fossa tumor, arteriovenous malformation and head surgery. Results: The diameter of basilar artery or vertebral artery in 44 cases was ranged from 4.9 to 10 mm, with an average of(7.67±3.62);The shape of the upper section of basal artery was circular in 29 cases and was strip in 15 cases;30 cases were with homogeneous density;4 cases were with edge macular calcification. Forty-four cases were all with visible cerebral atrophy, 12 cases were combined with simple cerebral infarction, 3 cases were with cerebral infarction and hemorrhage, 4 cases were with hydrocephalus. The height score of basal artery was 2 in32 cases(72.73%), 3 in 12 cases(27.27%), there was significant difference between the two groups(P<0.05). The location score was 2 in 33 cases(75.00%), 3 in 11 cases(25.00%), there was significant difference between the two groups(P<0.05). Conclusion: There are some characteristics in the CT manifestations of VBD, which should be combined with enhanced scanning features to further improve the accuracy of diagnosis and avoid missed diagnosis or misdiagnosis.