基于CTA量化评估椎基底动脉影像特征

CTA-Based Quantitative Evaluation of Vertebral-Basilar Artery Features

目的基于CTA扫描数据探讨椎基底动脉(VBA)影像解剖特征,为椎基底动脉延长症(VBD)诊断提供量化评估指标。方法回顾性分析符合纳入标准的行头颈CTA检查者302例,根据VBA形态特点分为均衡型和非均衡型两组,非均衡组分为L型和S型,测量各组椎动脉(VA)颅内段和基底动脉(BA)的直径、长度及BA分叉高度。结合容积再现图像,计算VA及BA的迂曲度(TI)。在寰枕关节水平层面、颈静脉孔水平、内听道水平、鞍背层面分别测量及计算VA、BA偏移正中矢状面的距离。血管的径线、长度及迂曲度均计算其95%可信区间(CI)。结果不同类型VBA年龄、性别构成上差异具有统计学意义(P<0.05)。左右VA直径、长度、迂曲度的95%CI分别为3.08~3.27 mm、2.68~2.87 mm,40.38~41.97 mm、39.89~41.75 mm、0.219~0.257 mm、0.140~0.203 mm。BA直径、长度、高度及迂曲度95%CI分别为3.14~3.29、28.13~29.16 mm、3.82~4.72 mm、0.091~0.119 mm。左右VA直径、迂曲度差异均具有统计学意义(P<0.05)。各类型VBA直径、长度、迂曲度差异具有统计学意义(P<0.05)。在颈静脉孔水平、内听道水平,各型VA、BA到正中矢状面的最大偏移距离差异具有统计学意义(P<0.05)。结论CTA定量数据能直观反映VBA形态学特点,为VBD的诊断提供定量影像学依据。

Objective To investigate the radiological anatomical characteristics of vertebral-basilar artery(VBA)based on CTA data,and to provide quantitative variables for the diagnosis of vertebrobasilar dolichoectasia(VBD).Methods a total of 302 patients with head-and-neck CTA met the inclusion criteria and were retrospectively analyzed.According to the morphological characteristics of the VBA,patients were divided into two groups:the equilibrium group and the non-equilibrium group.The non-equilibrium group was divided into L-type and S-type.The diameter,length of basilar artery(BA)and the intracranial segment of vertebral artery(VA),and height of the intracranial segment of BA were measured.The tortuosity index(TI)of VA and BA was calculated based on volume rendering images.VA and BA were measured and calculated at the level of atlantooccipital joint,jugularforamen,internal auditory canal and dorsum sellae.The maximum distance from BA to the median sagittal plane was measured.95%confidence interval(CI)was calculated for eachdiameter,length and TI of blood vessels.Results There were significant differences in age and gender between each type of vertebral-basilar artery(P<0.05).The 95%CI of diameter,length and TI of left and right VA were 3.08-3.27 mm,2.68-2.87 mm,40.38-41.97 mm,39.89-41.75 mm,0.219-0.257 mm,0.140-0.203,respectively.The 95%CI of diameter,length,height and TI of BA were 3.14-3.29 mm,28.13-29.16 mm and 0.091-0.119 mm,respectively.The diameter and TI between the left and right VA(P<0.05)were significantly different.The diameter,length and TI of VBA among different types were significantly different(P<0.05).The maximum distance from VA and BA to the median sagittal plane was significantly different(P<0.05)at the level of jugular foramen and internal auditory canal.Conclusion CTA quantitative data can vividly reflect the morphological characteristics of VBA and provide a quantitative imaging basis for the diagnosis of VBD.