椎动脉扭曲对颈椎横突孔解剖形态影像学改变的影响  

Rules of anatomic morphology changes between the vertebral artery tortuosity and transverse foramen

作　　者：闫廷飞[1] 孙璟川[1] 范丽[2] 望云[2] 杨勇[1] 陈德玉[1] 史建刚[1] 史国栋[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003 [2]第二军医大学附属长征医院影像科,上海200003

出　　处：《中华医学杂志》2016年第23期1806-1810,共5页National Medical Journal of China

基　　金：基金项目：国家自然科学基金（81371252）

摘　　要：目的 探究椎动脉扭曲与横突孔解剖形态的改变规律。 方法 2012年1月至2015年12月在第二军医大学附属长征医院骨科行颈椎增强CT确诊为椎动脉扭曲的患者60例作为观察组，随机抽取其他患者50例作为对照组，排除椎动脉扭曲及先天性横突孔狭窄、椎动脉缺如、椎动脉瘤等畸形、口腔内假体伪影导致测量困难者，收集患者基本临床信息，测量观察组椎动脉扭曲邻近节段及对照组各节段的横突孔面积（TF）与椎动脉截面积（VA），测量扭曲节段内径段长度、椎动脉长度并计算该段椎动脉扭曲系数（s）数据，分析患者影像资料及基本临床信息。 结果 观察组受累节段中C4节段为（25.91±10.13） mm2、C6节段TF为（31.93±17.91） mm2，高于对照组[（22.11±8.67） mm2，（27.19±7.89） mm2]，差异均有统计学意义（均P〈0.05）。TF与VA、s均呈正相关；观察组平均年龄（68.25±12.03）岁、血压（45例）及女性比例（39例）高于对照组[（61.32±11.32）岁，23例/22例）]，差异均有统计学意义（均P〈0.05）。 结论 C4、C6节段横突孔的面积可受累于椎动脉扭曲而扩大，可能与C6和C4横突孔周围骨质易发生退变有关，高龄、高血压及绝经期女性是横突孔扩大的危险因素。Objective To explore the rules of the anatomic morphology between vertebral artery tortuosity and transverse foramen. Methods From January 2012 to December 2015, 60 patients with vertebral artery tortuosity by means of analyzing the image data and basic clinic information as the observation group, and 50 patients randomly selected exclusive of vertebral artery tortuosity, absence of vertebral artery, vertebral artery aneurysm, cervical decomposition incomplete deformity and oral cavity prosthesis artifacts as the control group, the basic clinical information was collected; the transverse foramen area （TF） and vertebral artery cross-sectional area （VA） of the vertebral artery were measured in the observation group and the control group; internal diameter of vertebral artery tortuosity, length of vertebral artery were measured and; twisting coefficient （ s ） of the vertebral artery was calculated. Then the difference of the above- mentioned statistics was acquired. Results The C4 TF （25.91 ± 10. 13 ） mm and C6 TF （31.93±17.91 ） mm of the affected segment of the observation group were significantly higher than those in the control group[ （22. 11 ± 8. 67） mm, （27. 19 ±7. 89） mm] （P 〈 0. 05） ; VA and TF were positively correlated. The average age l （68.25 ± 12. 03 ） years ], blood pressure （45 cases）of the observation group and the proportion of the menopausal women （39 cases ） were higher than those in the control group [ （61.32 ±11.32） years,23/221 （P 〈 0. 05 ）. Conclusions The area of transverse foramen of CA and C6 could be affected by vertebral artery tortuosity. It might be related to the occurrence of bone degeneration around C6 and C4. The risk factors of the expansion of the transverse foramen might be advanced age, hypertension and menopausal women.

关 键 词：椎动脉扭曲 横突孔 影像学 解剖 

分 类 号：R687.3[医药卫生—骨科学]