CT血管成像研究压颈试验下Willis环的动态变化  

Dynamic Changes of Willis Circle by Manual Compression of the Proximal Common Carotid Artery During CT Angiography

作　　者：刘彩云[1] 苗新忠 孟冲[1] 

机构地区：[1]徐州医学院附属第三医院,江苏徐州221000

出　　处：《黑龙江医学》2015年第10期1118-1121,共4页Heilongjiang Medical Journal

摘　　要：目的探讨压迫单侧颈总动脉(压颈试验)是否引起Willis形态的变化。方法将100例(男52例,女48例)无颈动脉狭窄的健康志愿者纳入研究,行静息状态时和压颈试验时(以下简称两种状态下)CT血管成像(CTA)检查,采用配对检验分析两种状态下Willis环完整性分型、开放和闭塞的血管数、Willis前循环和后循环形态变化的血管数的差异。采用配对t检验分析ACo A、压颈同侧血管(ACA-A1、PCA-P1、PCOA)直径的差异。结果 Willis环完整性分型、开放和闭塞的血管数、Willis前循环和后循环变化血管数的差异(χ2=17.007、χ2=88.658、χ2=23.990,P=0.000、P=0.000、P=0.000<0.050)均有统计学意义,ACo A和ACA-A1直径的差异均有统计学意义,但PCOA和PCA-P1直径的差异均无统计学意义。结论压颈试验可以引起Willis环形态的变化,多层螺旋CTA结合压颈试验可用于显示初级侧支循环等个体化的脑血管储备功能,及时发现脑血管功能处于亚健康的人群。Objective To investigate whether the dysplasia of Willis circle is variable by manual compression of the proximal common carotid artery（ CCA） during CT angiography（ CTA）. Methods 100 healthy volunteers（ 52 male,48 female） without carotid artery stenosis were investigated. CTA was performed during the resting and oppression carotid artery. Variables including the integrity type of circle of Willis,blocked and open segment vascular redistribution of anterior and posterior circulation were analyzed by 2 test. The differences of the diameter including ACo A and carotid ipsilateral vessel（ ACA- A1,PCA- P1,PCOA,ACo A） were analyzed by t tests. Results The differences of two states in the integrity type of circle of Willis,blocked and open segment vascular redistribution of anterior and posterior circulation were statistically significant（ χ2= 17. 007,88. 658,23. 990,P = 0. 000,0. 000,0. 000 0. 050）. There was significant difference in the diameter of the ACo A and ACA- Al,but there was no statistically significant difference between diameter of the PCOA and PCA- P1. Conclusion Manual compression of the proximal common carotid artery（ CCA） can lead to the circle of Willis morphological changes,multi- slice spiral CT angiography（ CTA） combined with the test can be used to display individual primary collateral circulation and cerebral vascular reserve function,and timely detected sub- health population.

关 键 词：WILLIS环 颈动脉 体层摄影术 X线计算机 血管成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]