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目的探讨多层螺旋CT血管成像(MSCTA)在椎-基底动脉供血不足(VBAI)中的诊断价值。方法用Siemens 16 CT机对临床诊断VBAI的患者(试验组)30例与正常对照组30例行MSCTA检查,图像后处理采用多平面重组(MPR)、最大密度投影法(MIP)和容积再现(VR)等技术进行重建,观察椎-基底动脉的形态学变化和周围骨性结构的情况并进行对比分析。结果试验组30例中,椎动脉表现正常3例,走行迂曲3例,单侧变细12例,双侧变细2例,局部狭窄9例,单侧闭塞1例;2例基底动脉延长扩张,其中1例伴有动脉瘤形成,7例基底动脉局部狭窄。对照组30例中,仅有5例单侧椎动脉变细,其余均表现正常。2组中椎动脉表现正常和狭窄(血管变细和局部狭窄)的出现比率经统计学处理2组间有显著差异(χ2=28.72,P<0.01)。试验组30例中,单侧横突孔变小14例,对照组30例中,横突孔变小2例,2组中横突孔变小出现比率差异显著(χ2=12.27,P<0.01)。结论MSCTA对VBAI的病因诊断、治疗方案的选择有重要价值。
Objective To investigate the diagnostic value of multislice CT angiography (MSCTA) in vertebrobasilar insufficiency (VBAI). Methods 30 patients with VBAI (30 patients) and 30 normal controls (30 patients) were examined by MSCTA with Siemens 16 CT. The images were processed by multiplanar reconstruction (MPR), maximum density projection (MIP) and volumetric reconstruction VR) and other techniques to reconstruct the vertebrobasilar artery morphological changes and the surrounding bony structure were observed and compared. Results In 30 cases of test group, vertebral arteries were normal in 3 cases, tortuous in 3 cases, unilateral thinning in 12 cases, bilateral thinning in 2 cases, partial stenosis in 9 cases and unilateral occlusion in 1 case; 2 cases of basilar artery prolongation One case was accompanied by aneurysm formation and the other 7 was localized stenosis of basilar artery. Control group, 30 cases, only 5 cases of unilateral vertebral artery thinning, the rest were normal. The incidence of normal and stenotic vertebral arteries in both groups (vessel thinning and local stenosis) were significantly different between the two groups (χ2 = 28.72, P <0.01). Among the 30 cases in the experimental group, the number of unilateral transverse foramina was reduced in 14 cases. In the control group, the number of transverse foramina was reduced in 2 cases. The transverse foramina in two groups showed a significant difference (χ2 = 12.27, P <0.01) ). Conclusion MSCTA has important value in the diagnosis of VBAI and the choice of treatment options.