摘要
目的研究椎动脉优势(vertebral artery dominance,VAD)、基底动脉延长扩张(basilar artery dolichoectasia,BADE)与后循环梗死的独特相关性,探索椎基底动脉系统形态学改变的各项影像学指标以区分新发后循环梗死及前循环梗死的患者。方法选取新发后循环梗死患者50例作为研究组,选取同期住院新发前循环梗死患者50例作为对照组。回顾性分析2组的VAD及BADE的相关指标,筛选与后循环梗死相关的独立危险因素,并将筛选出的指标代入ROC曲线,找出区分新发前后循环梗死患者的最佳截断值。结果后循环梗死组与前循环梗死组在基底动脉理论长度(basilaf artery length,BAL)、存在VAD或基底弯曲患者所占比例方面比较差异有统计学意义(P<0.05)。Logistic分析显示,两侧椎动脉管径差值(D值)2级、3级是发生后循环梗死的独立危险因素(P<0.05)。ROC曲线显示,D值可对新发前、后循环梗死进行区分,其最佳截断值为0.41 mm,其AUC为0.753,特异度为0.78,敏感度为0.66。结论VAD增加了后循环梗死发生的风险,且D值达到2级以上此风险大大增加,MRA资料D值>0.41 mm的新发脑梗死患者更有可能患有后循环梗死。
Objective To study the unique correlation between vertebrobasilar artery dominance(VAD),basilar artery dolichoectasia(BADE)and posterior circulation infarction,and to explore various imaging indicators of morphological changes of vertebrobasilar artery system to distinguish patients with new posterior circulation infarction(PCI)and anterior circulation infarction(ACI).Methods Fifty patients with new PCI were selected as the research group,and 50 inpatients with new ACI during the same period were selected as the control group.The related indexes of VAD and BADE in the two groups were retrospectively analyzed,risk factors related to PCI were screened,and the screened indexes were inserted into ROC curve to identify the optimal cut-off value to distinguish the patients with new ACI and PCI.Results There was a significant difference between PCI group and ACI group in the basic artery length(BAL),the proportion of patients with VAD or basal curvature(P<0.05).Logistic analysis showed that grade 2 and grade 3 of the diameter difference(D value)of bilateral vertebral artery were independent risk factors for PCI(P<0.05).The ROC curve showed that the D value could distinguish the new ACI and PCI,with the optimal cutoff value of 0.41 mm,AUC of 0.753,specificity of 0.78,and sensitivity of 0.66.Conclusion VAD increases the risk of PCI,and the risk is greatly increased when D value is above level 2.Patients with cerebral infarction when his D value is greater than 0.41 mm are more likely to experience PCI.
作者
李嘉民
冯俊淇
张紫涵
LI Jia-min;FENG Jun-qi;ZHANG Zi-han(Department of Neurology,Shijiazhuang People′s Hospital,Hebei Province,Shijiazhuang 050023,China;Graduate School of Hebei Medical University,Shijiazhuang 050017,China)
出处
《河北医科大学学报》
CAS
2023年第3期259-263,共5页
Journal of Hebei Medical University
基金
石家庄市引进国外智力项目(20220049)。
关键词
椎底动脉供血不足
后循环梗死
前循环梗死
vertebrobasilar insufficiency
posterior circulation infarction
anterior circulation infarction
