摘要
目的探讨基底平行解剖扫描磁共振成像(BPAS-MRI)在颅内椎-基底动脉病变诊断中的应用价值。方法回顾性连续纳入2017年8月至2019年3月于中日友好医院神经科就诊主诉为“头晕或眩晕”并常规行头部三维时间飞跃法MR血管成像(3D TOF-MRA)及BPAS-MRI检查的80例患者,对双侧颅内段椎动脉、基底动脉在3D-TOF-MRA的基础上进行BPAS-MRI检查。对3D TOF-MRA血管显影正常的双侧椎动脉及基底动脉管径进行3D TOF-MRA与BPAS-MRI检查结果的比较,以观察BPAS-MRI检查对正常管径轮廓结构的显示情况。对3D TOF-MRA血管显影不正常的双侧椎动脉及基底动脉进行BPAS-MRI与3D TOF-MRA显影结果的对比分析,以探讨BPAS-MRI在颅内后循环血管病变中的诊断及鉴别作用。结果(1)80例患者共240支椎-基底动脉中,123支(51.2%)3D TOF-MRA显影正常,其左、右侧椎动脉及基底动脉的管径平均值3D TOF-MRA与BPAS-MRI比较,差异均无统计学意义(均P>0.05)。(2)117支(48.8%)血管在3D TOF-MRA上显影异常,其中39支(16.2%)血管仅通过MRA易漏诊或误诊,包括椎动脉发育不全15支(6.2%),椎动脉闭塞9支(3.8%),椎-基底动脉重度狭窄7支(2.9%),椎动脉发育不良5支(2.1%),椎-基底动脉扩张延长2支(0.8%)及椎动脉夹层1支(0.4%)。结论BPAS-MRI能够清晰显示颅内后循环系统血管外部轮廓结构,联合3D TOF-MRA提高了颅内椎-基底动脉病变诊断的准确性。
Objective To investigate the value of basiparallel anatomic scanning-magnetic resonance imaging(BPAS-MRI)in the diagnosis of intracranial vertebrobasilar artery disorders.Methods From August 2017 to March 2019,a total of 80 patients with“dizziness or vertigo”and treated in the Department of Neurology of China-Japan Friendship Hospital were prospectively enrolled.For these patients,first the conventional three-dimensional time of flight-magnetic resonance angiography(3D TOF-MRA)and then the BPAS-MRI were performed.The morphology and structure of bilateral intracranial vertebral artery and basilar artery were observed.For the normal intracranial vertebrobasilar artery which 3D TOF-MRA showed,the arterial diameters were compared between the 3D TOF-MRA and BPAS-MRI to observe the display of BPAS-MRI on the contour structure of normal arterial diameter.For the abnormal intracranial vertebrobasilar artery which 3D TOF-MRA showed,the results of BPAS-MRI and 3D TOF-MRA were compared and analyzed for exploring the diagnosis and differential role of BPAS-MRI on intracranial posterior circulation vascular disease.Results(1)Among the 240 vertebrobasilar artery vessels(80 patients)observed,123 vessels(51.2%)were normal on the 3D TOF-MRA.There was no statistical difference in the mean diameter of bilateral vertebral arteries and basilar artery measured by MRA and BPAS-MRI in the normal arteries(all P>0.05).(2)Among the 240 vertebrobasilar artery vessels,the other 117 vessels(48.8%)had abnormal morphology on the 3D TOF-MRA.Among them,39 vessels(16.2%)were easily missed or misdiagnosed by MRA only,including vertebral artery aplasia(15,6.2%),vertebral artery occlusion(9,3.8%),vertebrobasilar artery severe stenosis(7,2.9%),vertebral artery hypoplasia(5,2.1%),vertebrobasilar dolichoectasia(2,0.8%)and vertebral artery dissection(1,0.4%).Conclusion BPAS-MRI can clearly show the vascular outer contour of the intracranial vertebrobasilar artery,and its combination with 3D TOF-MRA can improve the accuracy of diagnosis for intracranial vertebrobasilar diseases.
作者
张志勇
张海波
焦劲松
乔亚男
谢晟
Zhang Zhiyong;Zhang Haibo;Jiao Jingsong;Qiao Yanan;Xie Sheng(Department of Neurology,China-Japan Friendship Hospital,Beijing 100029,China;不详)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2020年第9期531-537,共7页
Chinese Journal of Cerebrovascular Diseases
关键词
基底平行解剖扫描磁共振成像
椎-基底动脉狭窄
椎-基底动脉扩张延长症
椎动脉发育不良
椎动脉夹层
Basiparallel anatomic scanning-magnetic resonance imaging
Vertebrobasilar artery stenosis
Vertebrobasilar dolichoectasia
Vertebral artery dysplasia
Vertebral artery dissection
