脑血管DSA在椎动脉变异诊断中的价值  

Diagnostic value of cerebral vascular DSA in vertebral artery variation

作　　者：杨海华[1] 周晓梅[1] 刘立斌[1] 

机构地区：[1]首都医科大学大兴医院神经内科,北京102600

出　　处：《中华神经医学杂志》2017年第1期60-63,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨脑血管数字减影血管造影（DSA）对椎动脉变异诊断的价值，了解椎动脉变异的影像学特征。方法回顾性分析首都医科大学大兴医院神经内科自2010年10月至2015年5月收治的行脑血管DSA检查的946例患者的影像学资料，明确存在椎动脉变异患者的DSA特点及其不同变异种类和发生率。结果发生椎动脉变异140例。椎动脉起源异常16例（1．7％），其中左侧椎动脉起源异常14例，右侧椎动脉起源异常2例。1例（0．1％）永存三叉动脉起源于右侧颈内动脉。1例（0．1％）寰前节间动脉起源于左侧颈外动脉。10例（1％）椎动脉成窗式变异。25例（2．6％）小脑后下动脉起自颅外段较低部位。椎动脉发育不良92例（9．7％），其中右侧椎动脉发育不良54例，左侧椎动脉发育不良38例。发育不良的椎动脉中有12例椎动脉吻合异常．其中右侧椎动脉吻合异常4例，左侧椎动脉吻合异常8例。结论脑血管DSA可以清晰地显示椎动脉变异的位置、形态，掌握椎动脉变异的DSA影像学表现对提高脑血管病的诊断率及制定手术方案有着重要意义。Objective To evaluate the diagnostic value of cerebral vascular DSA in vertebral artery variation, understand the types of vertebral artery variation and the imaging characteristics of vertebral artery variation. Methods Nine hundred and forty-six patients received cerebral vascular DSA in our hospital from October 2010 to May 2015 were chosen. DSA characteristics of patients with vertebral artery variations were analyzed and the vertebral artery variation types and incidence were conformed. Results There were 140 patients with vertebral artery variations. Sixteen patients （1.7%） was diagnosed with anomalous origin of vertebral artery, including 14 of left vertebral artery anomalous origin, 2 of right vertebral artery anomalous origin. One patient （0.1%） had persistent trigeminal artery originated from the right internal carotid artery and one patient （0.1%） had proatlantal intersegmental artery originated from the left external carotid artery. The vertebral artery of 10 patients （1%） was found with fenestration. The posterior inferior cerebellar artery of 25 patients （2.6%） was originated from the lower portion of extracranial location. Ninety-two patients （9.7%） were found with vertebral artery hypoplasia, including 54 with right vertebral artery hypoplasia and 38 with left vertebral artery hypoplasia. There were 12 patients with anastomosis abnormalities in the vertebral artery hypoplasia, including 4 with right vertebral artery anastomosis abnormalities, and 8 with left vertebral artery anastomosis abnormalities. Conclusion Cerebral vascular DSA can clearly show the location and shape of vertebral artery variation, and it is important in the clinical diagnosis and treatment of cerebrovascular disease, interventional treatment and posterior fossa surgery.

关 键 词：椎动脉 动脉变异 数字减影血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]