前交通动脉瘤患者颈内动脉形态及大脑前动脉供血特征研究  

The morphology of internal carotid artery and the characteristics of blood supply from anterior cerebral artery in anterior communicating aneurysms

作　　者：杨娇 管生[1] 郭新宾[1] 范锋[1] 徐远杰 YANG Jie;GUAN Sheng;GUO Xinbin;FAN Feng;XU Yuanjie.(Department of Neurointervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, Chin)

机构地区：[1]郑州大学第一附属医院神经介入科,450052

出　　处：《介入放射学杂志》2018年第6期561-564,共4页Journal of Interventional Radiology

摘　　要：目的 探讨前交通动脉瘤患者颈内动脉(ICA)形态及大脑前动脉供血特征。方法 回顾性分析资料完整的183例前交通动脉瘤患者临床及MRA、DSA检查数据。根据MRA上双侧前交通动脉(ACA)和ICA是否对称,将前交通动脉瘤患者ICA形态分为4型:Ⅰ型为双侧ACA、ICA对称,Ⅱ型为双侧ACA对称、ICA不对称,Ⅲ型为双侧ACA不对称、ICA对称,Ⅳ型为双侧ACA、ICA不对称。分别超选择插管至左、右ICA作DSA造影,观察前交通脑动脉瘤供血情况。结果 183例前交通动脉瘤患者中ACA对称83例,ACA不对称100例;ICA对称75例,ICA不对称108例;ICA形态分型显示Ⅰ型67例(36.6%),Ⅱ型7例(3.8%),Ⅲ型16例(8.7%),Ⅳ型例93(50.9%)。ICA造影显示,无论ACA或ICA对称与否,前交通动脉瘤主要由一侧ACA供血(125例由左ACA,58例由右ACA供血),另一侧ICA多向同侧ACA供血,不向瘤体供血。结论 前交通动脉瘤患者ICA形态以Ⅰ型(对称)和Ⅳ型(不对称)为主,但无论ACA或ICA对称与否,瘤体多由一侧ACA供血。Objective To explore the morphology of internal carotid artery （ICA） and the characteristics of blood supply from anterior cerebral artery in anterior communicating aneurysms. Methods The MRI and DSA findings of 183 patients with ICA who had complete clinical data were retrospectively analyzed. According to whether bilateral anterior communicating arteries （ACA） and ICA were symmetrical or not on MRI, the ICA morphology of patients with anterior communicating aneurysm was classified into 4 types： type Ⅰ （having symmetrical ACA and ICA）, type Ⅱ （having symmetrical ACA and asymmetrical ICA）, type Ⅲ （having asymmetrical ACA and symmetrical ICA）, and type Ⅳ （having asymmetrical ACA and asymmetrical ICA）. DSA was performed with super-selective catheterization of both left and right ICAs to check the blood supply of anterior communicating aneurysm. Results Of the 183 patients with anterior communicating aneurysm, symmetrical ACA was observed in 83 and asymmetrical ACA in 100, symmetrical ICA in 75 and asymmetrical ICA in 108. Typing results of ICA morphology showed that type Ⅰ was seen in 67 patients （36.6%）, type Ⅱ in 7 patients（3.8%）, type Ⅲ in 16 patients （8.7%）, and type Ⅳ in 93 patients （50.9%）. ICA angiography revealed that, regardless of whether bilateral ACAs or ICAs were symmetrical or not, anterior communicating aneurysm was mainly supplied by unilateral ACA; the anterior communicating aneurysm obtained its blood supply from left ACA in 125 patients and from right ACA in 58 patients. Conclusion In patients with anterior communicating aneurysm, the main forms of ICA are type Ⅰ （symmetrical） and type Ⅳ （asymmetrical）. However, regardless of ACA or ICA is symmetrical or asymmetrical, the aneurysm is mainly supplied by unilateral ACA.

关 键 词：磁共振血管造影 颅内动脉瘤 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]