颈内动脉颅外段打折的影像诊断与临床意义  

Angiographic features and clinical significance of kinking of extracranial internal carotid artery

作　　者：张迎光[1] 朱吉祥[1] 李贵福[1] 白小欣[1] 朱文燕[1] 黄胜平[1] 李铁林[1] 林浩[1] 罗望池[1] 

机构地区：[1]广东省中医院神经三科,广州510120

出　　处：《中华放射学杂志》2009年第2期181-184,共4页Chinese Journal of Radiology

摘　　要：目的探讨颈内动脉颅外段打折的临床表现和影像特征及临床意义。方法对21例颈内动脉颅外段打折患者的临床和影像资料进行了系统性回顾分析。结果经Fisher确切概率法检验。结果7例患者无临床症状，14例有不同程度的脑供血不足症状，其中5例患者显现出该病的一个特征性临床表现，即转颈或头颈部于特定位置可诱发临床症状。全脑DSA可以准确地观察到颈内动脉颅外段打折的部位及血管狭窄程度。在动脉狭窄度（α）〈66％、80％〉α≥66％和α≥80％的患者中，有临床症状者分别占3／5、7／10和4／6，其差异经Fisher确切检验无统计学意义（P〉0．05）。结论颈内动脉颅外段打折是一种较常见的血管变异，并且是一种潜在的疾病。全脑DSA是发现该变异的可靠方法。Objective To investigate the clinical manifestations, angiographic features and clinical significance of kinking of extracranial internal carotid artery （ICA）. Methods The clinical and radiological data of 21 patients with kinking of extracranial ICA were retrospectively reviewed in our hospital from April 2003 to July 2007. Fisher exact test was performed. Results Of the 21 patients, 7 had no clinical symptoms, the other 14 showed manifestations of cerebral ischemia with varying degree. One of the characteristic clinical manifestations that neck rotation or specific positions of head and neck might induce the occurrence of clinical symptoms was found in 5 cases. The whole-brain coverage DSA accurately showed the location of kinking of extracranial ICA and the degree of vascular stenosis. In patients with α 〈 66%, 80% 〉α≥66% and α≥180%, clinical symptoms were found in 3 out of 5,7 out of 10 and 4 out of 6 patients, respectively. Fisher exact test revealed that the positive rates of clinical symptoms in three groups had no significant difference （P 〉 0. 05）. Conclusion Kinking of extracranial ICA is a frequent vascular morphologic variation, and it is also a kind of potential disease. The whole-brain coverage DSA is a relatively reliable method to detect this variation.

关 键 词：颈动脉狭窄 血管造影术 数字减影 脑血管造影术 

分 类 号：R686[医药卫生—骨科学]