CT平扫联合CT血管成像在老年椎基底动脉延长扩张症中的应用价值  

Application of CT plain scan and multi-slice spiral CT angiography in diagnosis of vertebrobasilar dolichoectasia in elderly

作　　者：杨飞[1] 朱晓龙[1] 陈静[2] 朱月香[1] 崔书君[1] 

机构地区：[1]河北北方学院附属第一医院CT室,河北张家口075000 [2]河北北方学院附属第一医院MRI室,河北张家口075000

出　　处：《临床荟萃》2015年第3期301-304,共4页Clinical Focus

摘　　要：目的探讨多排螺旋CT平扫联合CT血管成像(CTA)对诊断老年椎基底动脉延长扩张症(VBD)的应用价值,为临床早期预防及治疗提供参考依据。方法收集就诊于本院经临床及影像学检查诊断为VBD的患者,分析总结CT平扫及CTA资料、临床资料,将VBD患者分为老年组及非老年组,分析比较两组间临床表现、影像学表现及后循环脑梗死的发生率。结果 CTA明确诊断为VBD患者13例,CT平扫可明确诊断为VBD 10例,CT平扫对VBD诊断的阳性率76.9%(10/13)。CT平扫同时还可发现颅内其他病变。基底动脉测量的直径CT平扫较CTA测量结果稍偏大。CTA可清楚显示动脉扩张、迂曲、延长及偏移的情况及程度,可直接测量扩张血管长度、直径。老年组基底动脉(BA)直径、椎动脉(VA)直径、BA高度评分、BA水平移位评分均高于非老年组。老年组脑干压迫征1例,后循环脑梗死2例。结论 CT平扫对VBD诊断具有较高的阳性率,可作为VBD的影像学筛查方法之一。CTA是一种有效的诊断VBD的检查技术。CT平扫联合CTA为临床诊断和治疗VBD提供可靠的影像学依据。VBD在老年人中发病率较高,与后循环梗死有关。Objective To observe the pathogenesis, clinical manifestations and image features of the patients with vertebrobasilar dolichoectasia（VBD） using CT plain scan and multi-slice spiral CT angiography（MSCTA）, and to provide some references for the clinical diagnosis and early prevention and treatment of VBD. Methods VBD patients diagnosed with clinical presentations and imaging features in our hospital were enrolled in this study. CT plain scan and MSCTA data as well as clinical data of each patient were analyzed. According to the age, the VBD patients were divided into elderly group and non-elderly group. The clinical manifestations, image findings and the incidence of cerebral infarction in posterior circulation were compared. For all cases, the images were analyzed by two radiologists with double blind method. Results A total of 13 patients with VBD were enrolled, among which 10 cases could be clearly diagnosed by CT plain scan and all of the 13 cases diagnosed by MSCTA. The sensitivity of CT plain scan for VBD was 76.9%（10/13）. Other intracranial lesions could also be found by CT plain scan at the same time. The diameter of the basilar artery measured by CT plain scan was slightly larger than that measured by MSCTA. MSCTA could also clearly display the expansion, circuity, prolonging, and migration of VBA, so that the length and diameter of the expanded blood vessels could be directly measured. The average VBA diameter, height of BA bifurcation and lateral extent of BA in the elderly group were higher than those of the non-elderly group. There were one patient with brain stem compression and two patients with posterior circulation ischemia in the elderly group. Conclusion CT plain scan is of high sensitivity in the diagnosis of VBD, which can be used as one of the imaging screening methods in the diagnosis of VBD. However, MSCTA is an effective diagnostic technique of VBD. Thus, CT plain scan combined with MSCTA can provide a more reliable basis for the clinical diagnosis and treatment of VBD. The inc

关 键 词：椎底动脉供血不足 体层摄影术 螺旋计算机 血管造影术 老年人 

分 类 号：R743.9[医药卫生—神经病学与精神病学]