眩晕与脑基底动脉血流量改变的相关性分析

Correlation between vertigo and changes of blood flow volume in cerebral basilar artery

目的探讨眩晕与基底动脉(BA)血流量变化的相关性。方法采用相位对比法磁共振成像(PC-MRI)对健康志愿者(对照组)及眩晕发作患者(症状组及病变组)的BA血流量进行测量并比较分析。进行常规头颅MRI检查,收集T2WI FLAIR有/无腔隙性脑梗塞及白质病变的眩晕患者11例为病变组,15例为症状组,健康志愿者23名为对照组,三组均对BA进行PCMRI检查,使用工作站的QFLOW序列,对BA某一次心动周期成像进行感兴趣区(ROI)后处理,获得相应的时相-流速曲线以及相关血流动力学数值,记录BA的血管平均流量(MF)、平均流速(MV)及每搏量(SV)。采用SPSS 22.0统计软件,使用独立样本t检验方法,分别比较病变组、症状组与对照组BA的MF变化值。结果病变组基底动脉平均流量、平均流速及每搏量分别为(1.27±0.43)ml/s、(29.98±12.26)cm/s及(0.99±0.44)ml,以上3项指标病变组均较对照组低,两组比较差异均有统计学意义(平均流量t=2.16,P<0.05;平均流速t=2.86,P<0.01;每搏量t=1.83,P<0.01)。症状组基底动脉平均流量、平均流速及每搏量分别为(1.32±0.25)ml/s、(34.32±1.79)cm/s及(0.99±0.52)ml,以上3项指标症状组均较对照组低,两组比较差异均有统计学意义(平均流量t=3.16,P<0.01;平均流速t=3.26,P<0.01;每搏量t=2.69,P<0.05)。结论PC-MRI检查对脑实质及脑血管发生缺血性病变,眩晕患者其BA流速及流量等参数均降低有指导作用。

Objective To discuss the correlation between vertigo and changes of blood flow volume in cerebral basilar artery(BA).Methods Using phase contrast magnetic resonance imaging(PC-MRI),we measured blood flow volume in cerebral basilar artery from the volunteers and the patients with vertigo(divided into symptom group and pathological group)and then analyzed the data.After routine MRI examination on head,eleven patients with vertigo who did not have lacunar infarction were collected as the symptom group.Fifteen patients with vertigo and lacunar infarction were collected as the pathological group.The volunteers came to the control group.All images were post-processed on dedicated Q-FLOW workstation and the basilar artery hemodynamic parameters and phase-velocity curve in a heartbeat cycle could be obtained.The mean flow(MF),mean velocity(MV)and stroke volume(SV)were recorded.The differences of mean flow of the basilar artery among three groups were compared by SPSS 22.0 software.Results The mean flow,mean velocity and stroke volume of the basilar artery in symptom group were lower than those in the control group(the mean flow(1.27±0.43)ml/s vs(1.62±0.45)ml/s,t=2.16,P<0.05;mean velocity(29.98±12.26)cm/s vs(41.48±10.30)cm/s,t=2.86,P<0.01;stroke volume(0.99±0.44)ml vs(1.35±0.57)ml,t=1.83,P<0.01).Those data of the basilar artery in pathological group were lower than those in the control group(the mean flow(1.32±0.25)ml/s vs(1.62±0.45)ml/s,t=3.16,P<0.01;mean velocity(34.32±1.79)cm/s vs(41.48±10.30)cm/s,t=3.26,P<0.01;stroke volume(0.99±0.52)ml vs(1.35±0.57)ml,t=2.69,P<0.05).Conclusion The basilar artery of patients with vertigo has a decrease not only in the aspect of mean flow but also in mean velocity and stroke volume.The data between the symptom group or pathological group and the control group have statistical difference by one-Way ANOVA(P<0.05).PC-MRI examination has instructive effect on clinical diagnosis and treatment.