磁共振弥散加权成像联合CTA对基底动脉尖综合征(TOBS)的诊断价值  

The diagnosis value of combination MRI,DWI and CTA to TOBS

作　　者：张波[1] 周胜利[1] 苗重昌[1] 杨涛[1] 

机构地区：[1]江苏省连云港市第一人民医院影像科,江苏连云港222002

出　　处：《医学影像学杂志》2011年第10期1461-1464,共4页Journal of Medical Imaging

摘　　要：目的:总结MRI弥散加权成像(DWI)序列对基底动脉尖综合征的诊断价值,运用CTA技术探寻TOBS的发病原因。方法:回顾性分析26列TOBS患者的常规MRI和DWI影像资料以及21例TOBS患者的椎-基底动脉CTA表现,对比不同MR序列对病灶的发现率及病灶的分布范围,分析椎-基动脉血管结构有否病变。结果:梗塞灶呈多发性分布于双侧丘脑、中脑、小脑、枕叶及颞叶内侧,26例TOBS患者DWI共发现183个病灶,远较T2WI发现的136个病灶为多(134.6%),其中呈对称性分布者21例(80.8%),另5例(19.2%)呈单侧分布。21例行CTA检查患者中14例(66.7%)有椎基底动脉形态异常,其中2例基底动脉瘤,3例椎动脉瘤,7例椎-基底动脉壁存在粥样硬化斑。结论:弥散加权成像(DW)是早期诊断TOBS的最敏感影像检查技术,CTA可追溯TOBS的部分栓塞原因,两者结合可加强TOBS的病因诊断。Objective：To explore the diagnosis value of MRI, DWI and CTA of TOBS. Methods：The conventional MRI and DWI image material of 26 cases of TOBS were retrospectively analyzed so as to contrast different infarction finding rate with different MR sequence and observe the distribution range of infarctions, the CTA manifestation of 21cases of TOBS were analyzed to observe vererbral artery and bailary artery constructions. Results：The focus of infarction mainly distribute in both sides of the thalamus, midbrain, cerebellum, occipital lobe and internal side of temporal lobe. Total 183 infarction focuses of 26 cases discovered by DWI are more than 136 focuses fund by T2WI （ 134. 6 % ）. There were 21 cases （80.8%） with symmetrial infarction and 5 cases （19.2%） with unilateral infarction. 14 cases CTA （66.7 % ） of 21 cases showed abnormal performance in vertebal and basilar artery, including 2 cases of basilar artery aneurysm, 3 cases of vertebral artery aneurysm and 7 cases of arteriosclerosis in vertebral and basilar artery. Conclusion：DW is the most sensitive image-examine technique in making early phase diagnosis of TOBS. CTA can backward part pathogen of TOBS. The combination of two technique can reinforce pathogen diagnosis of TOBS.

关 键 词：基底动脉尖综合征 磁共振成像 CT血管造影成像 

分 类 号：R743[医药卫生—神经病学与精神病学]