MRA基底动脉不显影是后循环缺血预后不良的影像学征象  

Non-visualization of Basilar Artery on MR Angiography as a Poor Prognostic Sign in Patients with Posterior Circulation Ischemia

作　　者：杨璐[1] 曲方[1] 何凡[1] 吕彦[1] 王而强[1] 陈会生[1] 

机构地区：[1]沈阳军区总医院神经内科,110840

出　　处：《中国临床神经科学》2015年第2期138-142,共5页Chinese Journal of Clinical Neurosciences

摘　　要：目的：探讨后循环缺血患者中磁共振血管造影（MRA）基底动脉不显影的临床特点和神经影像特点与预后的关系。方法回顾性分析MRA上基底动脉不显影的18例后循环缺血患者的临床资料、影像学所见以及临床结局。男11例，女7例，年龄43-80岁，平均64.8岁。结果18例患者中，高血压病14例（77.8%），脑梗死13例（72.2%），心脏病9例（50.0%）。入院时：NIHSS评分（12.11±6.92）分，GCS评分（9.44±4.80）分，其中10例呈昏迷状态（GCS评分≤8分），梗死评分（3.75±1.38）分。18例患者MRA上基底动脉和双侧椎动脉颅内段几乎不显影。出院时：结局较好者2例（11.1%）；结局不良者16例（88.9%），其中住院期间死亡6例（1/3患者死亡）。结论MRA基底动脉不显影的后循环缺血患者，系后循环多个血管支配区梗死，预后很差。Aim To identify clinical or radiological measures in posterior circulation ischemia patients with basilar artery absent on magnetic resonance angiography （MRA） that could assist in predicting a clinical outcome. Methods The risk factors, clinic and radiological features, and functional outcomes were assessed in 18 patients with posterior circulation ischemia whose basilar arteries were not completely visualized on MRA. The total of 11 males and 7 females, aged 43 to 80 years with a mean year of 64.8. Results Out of 18 patients included, 14 patients（77.8%）had a history of hypertension, 13（72.2%） of cerebral infarction, 9（50.0%）of heart diseases. The admission NIHSS scores were （12.11±6.92）. The admission GCS scores were （9.44±4.80）, of which 10 cases （55.6%） were in comatose （GCS score≤8）. The infarction score were （3.75±1.41）. The basilar artery as well as bilateral intracranial vertebral arteries were absent on MRA. The clinical outcomes at discharge were favorable in 2 cases （11.1% ） and poor in 16 cases （88.9%）, of which 6 patients died during hospitalization. Conclusion The patients with posterior circulation ischemia and complete non-visualization of the basilar artery on MR angiography have multiple territory infarctions and rather poor prognosis.

关 键 词：后循环缺血 磁共振血管成像 基底动脉不显影 

分 类 号：R743[医药卫生—神经病学与精神病学]