论文部分内容阅读
目的探讨椎动脉发育不良的螺旋CT血管造影(spiralCTangiography,SCTA)表现和临床意义。方法180例临床诊断为椎-基动脉供血不足患者行SCTA检查。造影剂为浓度350mg/100ml的Omnipaque80～100ml,足背静脉注射。流率3ml/s,延迟时间由预扫描确定。层厚、间隔分别为3mm和4.5mm。重建间隔1.5mm。采用多平面容积重建(MPVR)和表面遮盖法重建(SSD),用原始横断面图像测量椎动脉直径。CT显示有椎动脉狭窄者于1周内行DSA检查。结果360根椎动脉中共发现78根(21.7%)有全程狭窄,平均直径1.3mm(1.0～1.5mm)。其中左侧24根,右侧54根。其中有20根同时伴有局限性进一步狭窄。对侧椎动脉合并局部管壁钙化13根(16.7%),合并V1段扭曲20根(25.6%),合并钩椎关节增生压迫11根(14.1%)。DSA检查结果与SCTA完全一致。结论椎动脉发育不良是椎-基动脉供血不足的常见原因之一,SCTA可以确诊并能取代诊断性DSA检查。
Objective To investigate the clinical manifestations and clinical significance of spiral CT angiography (SCTA) with hypoplastic vertebral artery. Methods 180 cases of clinical diagnosis of vertebrobasilar insufficiency patients underwent SCTA examination. Contrast agent concentration of 350mg / 100ml Omnipaque80 ~ 100ml, dorsal vein injection. Flow rate 3ml / s, the delay time determined by the prescan. Layer thickness, spacing, respectively 3mm and 4.5mm. Reconstruction interval 1.5mm. Multiplanar volume reconstruction (MPVR) and surface occlusion reconstruction (SSD) were used to measure the diameter of the vertebral artery with the original cross-sectional images. DSA was performed within 1 week on the CT scan showing vertebral artery stenosis. Results A total of 78 (21.7%) of 360 vertebral arteries were found to have a complete stenosis with an average diameter of 1.3 mm (1.0 to 1.5 mm). There are 24 on the left and 54 on the right. Of these, 20 were further limited by limitations. In the contralateral vertebral artery, there were 13 (16.7%) localized calcification of the wall and 20 (25.6%) of the patients complicated with the V1 segment. Eleven patients (14.1%) had combined hyperplasia of the lumbar joint. DSA test results and SCTA exactly the same. Conclusion Vertebral artery dysplasia is one of the most common causes of vertebrobasilar insufficiency. SCTA can be diagnosed and can replace diagnostic DSA.