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目的:探讨椎动脉型颈椎病患者椎动脉三维CT血管成像的影像学特征及其临床意义。方法:86例拟诊为椎动脉型颈椎病患者接受椎动脉三维CT血管成像(three-dimensionalCTangiographicimaging,3D-CTA)检查,重建椎动脉和颈椎骨及颅内椎-基底动脉,在CTA上观察椎动脉的外形、行经及与颈椎骨的关系。结果:86例患者的椎动脉CTA重建图像中血管先天畸形15例,血管硬化21例,骨质增生或纤维组织增生致血管局部受压38例,血管闭塞1例,血管瘤1例;椎动脉正常10例。先天畸形中发育异常9例,表现为整条血管纤细,直径小于2.5mm;走行异常6例。血管硬化表现为血管壁粗糙、不规则、粗细不均匀、钙化等。结论:CTA诊断椎动脉先天畸形和血管硬化有独到之处,椎动脉先天畸形和血管硬化是椎动脉型颈椎病发病的重要因素之一。
Objective: To investigate the imaging features and clinical significance of three-dimensional CT angiography of vertebral artery in patients with vertebral artery-type cervical spondylosis. Methods: Eighty-six patients with vertebral artery type cervical spondylosis were examined by three-dimensional CT angiographic imaging (3D-CTA). The vertebral artery, cervical vertebrae and intracranial vertebral-basilar artery were reconstructed. The appearance of arteries, passing and the relationship with the cervical vertebra. Results: CTA reconstructed images of vertebral artery in 15 cases, 15 cases of vascular congenital malformations, 21 cases of hardening of the arteries, hyperplasia of fibroelastoma caused local vascular compression in 38 cases, vascular occlusion in 1 case, hemangiomas in 1 case, vertebral artery Normal 10 cases. Abnormalities in congenital malformations in 9 cases, showing the entire stenosis, diameter less than 2.5mm; walking abnormalities in 6 cases. Vascular sclerosis manifested as rough, irregular vascular wall, uneven thickness, calcification and so on. Conclusion: CT diagnosis of congenital anomalies of vertebral artery and vascular sclerosis are unique, congenital anomalies of vertebral artery and vascular sclerosis is one of the important factors in the incidence of cervical spondylotic vertebral artery disease.