原始三叉动脉的分型特点及与脑梗死的相关性

The correlation between classification characteristics of primitive trigeminal artery and cerebral infarction

目的探讨原始三叉动脉(persistent trigeminal artery, PTA)的分型和血供特点及与脑梗死的相关性。方法回顾性分析92例经CTA和MRA检查出的PTA的影像学资料,分析其分型、血供特点及与脑梗死的相关性。结果 92例PTA患者的平均发病年龄为(59.6±17.5)岁,其中,男性38例(41.3%),女性54例(58.7%),女性高于男性。CTA发现36例(39.1%),MRA发现56例(60.9%)。41例位于右侧(44.6%),51例位于左侧(55.4%),未发现双侧型。按Weon分型,Ⅰ型29例(31.5%),Ⅱ型18例(19.6%),Ⅲ型20例(21.7%),Ⅳ型13例(14.1%),Ⅴ型5例(5.4%),特殊类型7例(7.6%)。按Salas分型,外侧型69例(75%),中间型23例(25%)。合并基底动脉发育不良54例(58.7%)(含双椎动脉颅内段发育不良47例),Ⅰ型14例(48.3%),Ⅱ型15例(83.3%),Ⅲ型12例(60.0%),Ⅳ型8例(61.5%),Ⅴ型3例(60.0%),特殊类型2例(28.6%),以Ⅱ型合并基底动脉发育不良的比例最大。伴有脑梗死35例(38.0%),Ⅰ型8例(27.6%),Ⅱ型11例(61.1%),Ⅲ型7例(35.0%),Ⅳ型6例(46.2%),Ⅴ型2例(40.0%),特殊类型1例(14.3%),以Ⅱ型伴发脑梗死的比例最高。结论 CTA和MRA可较好的显示PTA的解剖特点及其分型,辅以椎-基底动脉发育不良的情况,能更为全面的诠释各型PTA的血液循环特点,评估与脑梗死的相关性,对临床具有指导意义。

Objective To explore the correlation between classification characteristics and blood supply characteristics of primitive trigeminal artery and cerebral infarction. Methods Totally, 92 patients who were diagnosed as PTA by CTA and MRA, were collected retrospectively, and the classification, blood supply characteristics and correlation with cerebral infarction were analyzed. Results There were more females than males in 92 patients, whose average age was 59.6±17.5, 36(39.1%). Those were detected by CTA and 56 cases(60.9%) by MRA.There were 41 cases at the right side(44.6%) and 51 cases at the left side(55.4%). Weon type Ⅰ was 29 cases(31.5%), type Ⅱ was 18 cases(19.6%), type Ⅲ was 20 cases(21.7%), type Ⅳ was 13 cases(14.1%), type Ⅴ was 5 cases(5.4%), and special type was 7 cases(7.6%);According to Salas type, 69 cases(75%) were lateral type, 23 cases(25%) were intermediate type. There were 54 cases(58.7%) with dysplasia of basilar artery(including 47 cases with dysplasia of intracranial double-vertebral artery), type Ⅰ was 14 cases(48.3%), type Ⅱ was 15 cases(83.3%), type Ⅲ was 12 cases(60.0%), type Ⅳ was 8 cases(61.5%), type Ⅴ was 3 cases(60.0%), special type was 2 cases(28.6%). Type Ⅱ with dysplasia of basilar artery was the most common. There were 35 cases(38.0%) with cerebral infarction, type Ⅰ was 8 cases(27.6%), type Ⅱ was 11 cases(61.1%), type Ⅲ was 7 cases(35.0%), type Ⅳ was 6 cases(46.2%), type Ⅴ was 2 cases(40.0%), special type was 1 case(14.3%), Type Ⅱ presented with the highest proportion of cerebral infarction. Conclusion CTA and MRA can better display the anatomical characteristics and classification of PTA, and supplement with vertebrobasilar dysplasia, can more comprehensively interpret the blood circulation characteristics of PTA, and evaluate the correlation with cerebral infarction, which is of guiding significance in clinical practice.