椎基底动脉三维CT血管造影对颈性眩晕椎动脉寰枕段形态学改变的观察  

Pathomorphological change of the atlanto-occipital segment of vertebral artery related with cervical vertigo

作　　者：范炳华[1] 许丽[1] 林敏[1] 李伟[2] 汪芳俊[3] 徐泉珍[1] 

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310005 [2]浙江医院,浙江杭州310013 [3]浙江省中西医结合医院,浙江杭州310003

出　　处：《中国骨伤》2015年第1期39-42,共4页China Journal of Orthopaedics and Traumatology

基　　金：国家临床重点专科建设项目(国卫医发2013-42号);浙江省名老中医专家传承工作室(编号:GZS2012017);国家中医药管理局中医药科技专项课题(编号:06-07LP21);浙江省中医药管理局重点项目(编号:2008ZA007)~~

摘　　要：目的：探索颈性眩晕的椎动脉寰枕段（V3段）血管形态病理学改变。方法：1999年6月至2011年11月，采用椎-基底动脉CT血管造影三维重建技术（3D—CTA）对1680例颈性眩晕患者的血管形态影像进行回顾性分析，观察其椎动脉V3段血管形态病理学改变情况。其中男783例，女897例；年龄22-70岁，平均52．8岁，所有病例经多普勒检查显示椎基底动脉流速加快或减慢。结果：1680例颈性眩晕患者在V1-V4段有3360支血管被检测，血管异常支数有2778支，其中V1段有829支，V2段有421支，V3段有328支，V4段有1190支。颈性眩晕患者椎动脉V3段血管形态病理学有椎动脉血管痉挛（232支）、椎动脉血管缺如（37支）、椎动脉血管出孔异常（31支）、椎动脉血管局限性狭窄4种改变。结论：颈性眩晕的椎动脉V3段存在4种血管形态病理学改变，可以以3D—CTA检查结果来判断预后并采取适当的治疗方法．Objective ：To explore the pathomorphological change of the atlanto-occipital segment of vertebral artery （V3 part） related with cervical vertigo. Methods：From June 1999 to November 2011, the pathomorphological change of the atlantooccipital segment of vertebral artery were observed in 1 680 patients with cervical vertigo using 3D-CTA technology. The clinical data of these patients were analyzed. There were 783 males and 897 females, aged from 22 to 70 years old with an average of 52.8 years old. Doppler examination showed vertebral basilar artery flow velocity to speed up or slow down. Results：The blood vessel of 3 360 branches were detected in 1 680 patients and 2 778 branches were detected out vascular anomaly. And 829 branches were in V1 segment ,421 were in V2,328 were in V3,1 190 were in V4. The pathomorphologieal changes in the atlanto-oceipital segment （V3） of vertebral artery included angiospasm,congenital absence,abnormal exit,localized stenosis. Conclusion ：There are 4 kinds of pathomorphological changes in the atlanto-occipital segment of vertebral artery related with cervical vertigo. The 3D-CTA result can be used to judge prognosis and adopt reasonable treatment for the patients.

关 键 词：颈性眩晕 椎动脉寰枕段 血管形态 病理改变 

分 类 号：R739.41[医药卫生—肿瘤]