多排螺旋CT血管造影(MSCTA)对永存颈内-基底动脉变异的诊断价值及临床意义

Diagnostic Value and Clinical Significance of Multi-slice Spiral CT Angiography(MSCTA)in Permanent Internal Carotid Basilar Artery Variation

目的研究并总结永存颈内-基底动脉吻合的多排螺旋CT血管造影(MSCTA)影像学特点及分型,并探讨其相关临床意义。方法收集整理93例经头颈联合扫描多排螺旋血管造影(MSCTA)检查诊断为永存颈内-基底动脉患者影像学资料及临床资料。结果共收集93例永存颈内-基底动脉吻合病例,其中PTA 79例(1例为双侧发生,共80条永存动脉),PHA 6例,PIA 8例。永存颈内-基底动脉吻合患者常常伴发其他疾病,伴发动脉瘤20例(21.5%)、脑梗死12例(13%)、神经压迫症状3例(3%),合并后循环缺血21例(22.5%)。椎动脉发育不良为46例(49%)、基底动脉发育不良61例(65%)、其他变异17例(18%)。结论MSCTA可以快速、准确、安全、无创地对永存颈内-基底动脉进行诊断及分型,并能对其走行、毗邻关系及合并其他血管相关性疾病进行有效评估,熟悉这类血管变异有利于临床医生对于相关疾病的认识,并能指导临床制定治疗方案,提高手术安全性。

Objective To study and summarize the imaging characteristics and classification of multi-slice spiral CT angiography(MSCTA)in persistent internal carotid basilar artery anastomosis and explore its clinical significance.Methods We analyzed the imaging and clinical data of 93 persistent internal carotid-basilar artery patients diagnosed by multi-slice spiral angiography(MSCTA).Results A total of 93 cases of permanent internal carotid-basilar artery anastomosis were collected,including 79 cases of PTA(1 case was bilateral,with 80 permanent arteries),6 cases of PHA,and 8 cases of PIA.Patients with permanent internal carotid-basilar artery anastomosis are often associated with other diseases:including aneurysms in 20 cases(21.5%),cerebral infarction in 12 cases(13%),nerve compression symptoms in 3 cases(3%),and posterior circulation ischemia in 21 cases(22.5%).Vertebral artery dysplasia was found in 46 cases(49%),basilar artery dysplasia in 61 cases(65%),and other variations in 17 cases(18%).Conclusion MSCTA not only can quickly,accurately,safely,and noninvasively diagnose and classify the permanent internal carotid-basilar artery but also effectively evaluate its course,adjacent relationship,and other vascular-related diseases.Being familiar with this kind of vascular variation is helpful for clinicians to understand related diseases,make the right clinical decision and improve the safety of operation.