23例椎基底动脉扩张延长症患者磁共振成像与经颅多普勒超声特点分析  

Analysis of 23 patients with vertebrobasilar dolichoectasia according to magnetic resonance imaging and transcranial Doppler characteristics

作　　者：姚雪燕[1] 张志勇[1] 薛爽[1] 魏坤[1] 杨丽红[1] 朱秀静[1] 冯羿博[1] 

机构地区：[1]中日友好医院神经内科,北京100029

出　　处：《中日友好医院学报》2011年第1期15-17,22,F0003,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨椎基底动脉扩张延长症(VBD)患者磁共振成像(MRI)的分级及经颅多普勒超声(TCD)特点,以提高对VBD的诊断和预后的认识。方法:对23例经MRI确诊的VBD患者的临床及影像资料进行回顾分析,总结其MRI及TCD特点。结果:(1)本组患者以后循环缺血为主,临床表现以不同程度头晕最常见。(2)头颅MRI及磁共振血管成像(MRA)的诊断准确率均为100%。基底动脉分叉高度及基底动脉侧向偏移均以2级(Smoker分级法)最常见。(3)TCD分析:双椎动脉平均血流速度(Vm)≤20cm/s,基底动脉Vm≤30cm/s,同时伴有基底动脉侧向偏移程度3级者后循环梗死发生率高。结论:VBD临床表现多样,但表现为后循环缺血并不少见,尤其是高龄患者;MR结合TCD特点对诊断及评价预后有一定意义。Objective：To identify magnetic resonance（MR）classification and transcranial Doppler（TCD）characteristics of vertebrobasilar dolichoectasia（VBD）and improve diagnostic and prognostic recognition of VBD.Methods：The clinical information and MR and TCD characteristics of VBD findings of 23 patients with VBD diagonosed by MR were analyzed retrospectively.Results：（1）The cases with posterior circulation ischemia were more common,and the dizziness in different degrees was the most common clinical manifestation.（2）The diagnostic accuracy rate of cranial MRI and MRA were both 100%.The degree of bifurcation height or lateral deviation of basal artery was mainly regarded as the 2nd degree of Smoke＇s criteria.（3）The patient whose mean blood flow velocity（Vm） of bilateral vertebral arteries was ≤20cm/s,Vm of basal artery was ≤30cm/s,and with the 3rd degree of lateral deviation of basal artery in TCD,the incidence of cerebral infarction in posterior circulation was high.Conclusion：Clinical manifestations of VBD were various,but posterior circulation ischemia was not rare,especially for the elderly patients.To clarify the diagnosis and evaluate the prognosis,MR and TCD tests were of great significance.

关 键 词：椎基底动脉扩张延长症 后循环 脑梗死 磁共振成像 经颅多普勒超声 

分 类 号：R743.3[医药卫生—神经病学与精神病学]