颈内动脉狭窄或闭塞后交通动脉的DSA和MRA评价

The internal carotid artery stenosis or occlusion:the evaluation for the posterior communicating artery on DSA and MRA

目的 应用DSA、MRA研究颈内动脉狭窄或闭塞患者后交通动脉的变化。方法 分析74例颈内动脉狭窄或闭塞患者以及120例脑血管正常表现者的DSA和MRA结果。结果 疾病组中颈内动脉狭窄或闭塞同侧后交通动脉DSA出现率和对照组间无明显差异(P>0.05);在MRA上明显高于对照组(P<0.01);同侧后交通动脉的DSA和MRA测量值均较对照组增大(P<0.01)。对照组中,后交通动脉DSA出现率高于MRA(P<0.01),DSA和MRA其测量值无统计学差异(P>0.05);疾病组中,后交通动脉DSA出现率高于MRA(P<0.05),单侧和双侧病变其出现率和增粗率无明显差异。结论 后交通动脉在颈内动脉阻塞中有重要代偿作用,DSA上增粗及MRA上出现和增粗均有一定代偿意义。DSA对后交通动脉的评价有很高价值,MRA无创、整体性好,能从功能上评价其作用。

Objective To study the changes of the posterior communicating artery in patients with internal carotid artery (ICA) with severe stenosis or occlusion on digital subtract angiography (DSA) and magnetic resonance angiography (MRA). Methods DSA or MRA findings were analyzed in 74 patients with ICA stenosis or occlusion and in 120 persons selected in the control group, who were unremarkable on cerebral DSA or MRA. Results On DSA, the presence rate of ipsilateral posterior communicating artery (PCoA) between the study group and the control group had no significant difference; on MRA the rate in the study group was significantly higher than the control group (P < 0. 01 ), On DSA and MRA, the diameter of ipsilateral PCoA in the study group was larger than the control group ( P < 0. 01). In the control group, the presence rate of PCoA on DSA were sig-nificantlly higher than that on MRA. No significant difference was found between DSA and MRA on the diameter of PCoA (P > 0.05). In the study group, the presence rate of PCoA on DSA was significantly higher than that on MRA (P < 0. 05). The diameters of the three arteries had not significant difference between on DSA and on MRA(P > 0.05) .The presence rate of PCoA shown no significant difference between the cases with unilateral ICA involved and cases with bilateral ICA involved. Conclusion The posterior communicating artery is very important to the patients with the internal carotid artery stenosis or occlusion. Its dilatation on DSA and MRA or appearance on MRA shows its compensation. DSA is valuable in the evaluation of the posterior communicating artery. MRA is a noninvasive and functional imaging method for evaluation the posterior communicating artery.