双源CT双能量去骨血管成像诊断头颈部动脉开窗畸形的初步研究  

Preliminary study of dual energy bone removal CT angiography for the diagnosis of intra and extracranial arterial fenestration

作　　者：刁强[1] 彭晋[2] 张龙江[1] 周长圣[1] 罗松[1] 

机构地区：[1]南京军区南京总医院影像科,南京210002 [2]中国人民解放军第174医院放射科,厦门361003

出　　处：《医学研究生学报》2010年第10期1070-1073,共4页Journal of Medical Postgraduates

摘　　要：目的头颈部动脉开窗畸形不常见,相关影像学研究较少。文中探讨双源CT双能量去骨血管成像(dual energybone removal computed tomography angiography,DE-CTA)诊断头颈部动脉开窗畸形的临床运用价值。方法回顾性分析23例头颈部动脉开窗畸形的影像学表现和临床表现。23例均行头颈部CT血管造影(computed tomography angiography,CTA)检查,随后8例行头部MR血管造影(magnetic resonance angiography,MRA)检查,6例行数字减影血管造影(digital subtraction an-giography,DSA)检查,其中2例同时行MRA及DSA检查。结果23例头颈部动脉开窗畸形均为单发,15例位于基底动脉近段,其中1例合并颅内动脉动脉瘤(蛛网膜下腔出血);6例位于椎动脉,其中3例位于颅外段,3例位于颅内段;其余1例位于大脑前动脉近段,1例位于大脑中动脉起始处。所有病例均表现为头颈部动脉局限性重复。结论DE-CTA能有效去除骨结构,显示头颈部动脉开窗畸形的位置、形态和毗邻关系,是诊断头颈部动脉畸形的有效方法。Objective Arterial fenestration of the head and neck is uncommon,and there are few imaging reports on it.This study was to investigate the value of dual-energy computed tomography angiography（DE-CTA） in the diagnosis of intra-and extra-cranial arterial fenestration.Methods We introspectively studied the imaging and clinical manifestations of 23 cases of arterial fenestration of the head and neck.All the cases underwent craniocervical angiography（CTA）,8 of them followed by cranial magnetic resonance angiograms（MRA） and 6 by digital subtraction angiography（DSA）,and another 2 examined by CTA,MRA and DSA at the same time.Results A single artery was fenestrated in each of the 23 cases： 15 in the proximal portion of the basilar artery（1 complicated by intracranial aneurysm with subarachnoid hemorrhage）,6 in vertebral artery（3 in the extracranial and 3 in the intracranial portion）,and the other 2 in the intracranial artery（1 in the proximal portion of the anterior cerebral artery and 1 in the beginning of the middle cerebral artery）.All the cases exhibited localized vascular duplication.Conclusion DE-CTA,capable of effectively removing the bone structure and displaying the exact location,shape and adjacent structure of fenestration,is a useful tool for the diagnosis of fenestration in intra-and extra-cranial arteries.

关 键 词：开窗畸形 体层摄影术 X线计算机 双能量 

分 类 号：R814.42[医药卫生—影像医学与核医学]