大脑中动脉开窗的CT血管成像诊断  

Fenestration of middle cerebral artery:diagnostic value of CT angiography

作　　者：徐天才[1] 高凌云[2] 朱志平[1] 熊强[1] 张冰[1] 杨运俊[2] 

机构地区：[1]监利县人民医院放射科,湖北433300 [2]温州医科大学附属第一医院放射影像中心,浙江325000

出　　处：《放射学实践》2013年第10期1002-1005,共4页Radiologic Practice

摘　　要：目的:探讨CT血管成像(CTA)在大脑中动脉开窗变异中的诊断价值,提高对该血管变异的认识。方法:搜集2008年1月-2012年2月的3778例患者的CTA资料,将所有原始图像经容积重建(VR)和最大密度投影(MIP)进行三维重建,分析大脑中动脉开窗影像学特点。结果:3778例中发现大脑中动脉开窗6例(男5例,女1例),检出率为0.16%。所有开窗均位于M1段,其中M1段近段5例(4例呈裂隙型,1例呈凸透镜型),中段1例呈凸透镜型。左、右大脑中动脉开窗各3例,且有1例同时合并基底动脉开窗。1例由1支桥血管与大脑中动脉和大脑前动脉近端围成,1例伴有早期颞极动脉的分支起源于开窗的下支血管。6例中1例同时合并左侧大脑中动脉瘤、前交通动脉瘤及基底动脉梭形动脉瘤;1例伴有动静脉畸形(AVM);1例伴有静脉畸形。结论:CTA能快速、直观地显示大脑中动脉开窗变异及其合并的血管性病变,可作为其诊断的首选方法。Objective：To assess the value of CT angiography （CTA） in the diagnosis of fenestration of middle cere bral artery （MCA）,and to improve the understanding of this anomaly. Methods： A total of 3778 consecutive cerebral CTA studies performed between January 2008 and February 2012 were recruited. The original raw data were post processed to obtain the 3D reconstruction images with volume rendering （VR） and maximal intensity projection （MIP） techniques. The imaging characteristics of the fenestration were analyzed. Results：Of these 3778 cases,MCA fenestration was found in 6 ca ses （5 men and 1 woman）,representing an incidence of 0. 16%. The fenestration located at the proximal M1 segment in 5 cases with slit-like pattern in 4 cases and lens-like pattern in 1 case.the rest one at the middle M1 segment with a lense-like pattern. There were three cases at the right side and three at the left. One case had a branch crossed over MCA and the proximal segment of the anterior cerebral artery,one had an early branching of TPA arising from the inferior aspect of fen- estration. Association with MCA aneuryam,fusiform aneuryam of anterior communicating artery and basilar artery could be revealed in 1 case. Other anomalies included arteriovenous malformation （n= 1） and venous malformation （n= 1 ）. Conclusion：MCA fenestration and associated blood vessel anomaly could be demonstrated directly and quickly by CTA, which could be used as the first choice for diagnosis.

关 键 词：血管畸形 大脑中动脉 体层摄影术 X线计算机 

分 类 号：R816.1[医药卫生—放射医学]