颈动脉和椎-基底动脉间吻合血管变异的MR诊断  

Diagnosis of variants of carotid-vertebasilar anastomoses on MR angiography

作　　者：白敏[1] 赵立冬[2] 郭茜[2] Bai Min;Zhao Lidong;Guo Qian(Department of MR,Liaocheng People＇s Hospital,Shandong Province,Liaocheng 252000,Chin)

机构地区：[1]山东省聊城市人民医院磁共振室,252000 [2]山东省聊城市人民医院脑科医院影像科,252000

出　　处：《中华放射学杂志》2018年第7期502-506,共5页Chinese Journal of Radiology

摘　　要：目的利用头颈部MRA分析颈和椎-基底动脉间异常吻合血管的特点。 方法回顾性分析2009年6月至2015年12月于聊城市人民医院行头颈部MRA检查的7 246例患者的MRA图像，2名医师分析颈内动脉、颈外动脉和基底动脉或椎动脉间异常吻合血管特点，包括原始三叉动脉（PTA）、原始舌下动脉（PHA）和原始寰前节间动脉（PIA）。 结果7 246例患者中，共检出颈动脉和椎-基底动脉间异常吻合血管44例。PTA及PTA变异共39例，发生率0.54%；PTA 27例，PTA变异12例。PTA变异A型2例，B型10例。Uchino分型外侧型23例，内侧型4例。PTA均起源于颈内动脉海绵窦段C4段，与基底动脉吻合27例，与小脑上动脉吻合2例。吻合口下基底动脉发育不良7例，2例缺如。PHA 3例，发生率0.04%；2例起于同侧颈内动脉颅外段，1例起于颈外动脉；均位于右侧。PIA 2例，发生率0.03%；左侧1例，右侧1例。1例起于颈外动脉，1例起源于颈内动脉颅外段。34例并发头颈部其他血管变异。PHA均并发椎动脉缺如,1例PIA并发椎动脉发育不良。18例并发脑梗死，3例并发动脉瘤。 结论MRA能准确评价颈和椎动脉-基底间异常吻合血管变异特点，具有诊断意义。ObjectiveTo explore the feature of embryonic communication between the carotid and vertebro-basilar system using MRA of head and neck on MR. MethodsThe MRA images from 7 246 consecutive patients in Liaocheng People＇s hospital between June 2009 and December 2015 were retrospectively reviewed. The feature of embryonic communication between internal carotid, external carotid artery and vertebro-basilar system using MRA was analyzed by two doctors. ResultsForty-four cases of embryonic communication between the carotid and vertebro-basilar system were found. Thirty-nine cases of primitive trigeminal artery （PTA） and primitive trigeminal artery variants （PTAV） were detected by MRA. The prevalence of both PTA and PTAV was 0.54% （PTA, 27 cases;PTAV, 12 cases）. Twenty-three cases of PTA were lateral types;four cases were medial types. All PTA originated from C4 portion of internal carotid artery, of which 27 cases connected with the basilar artery and two cases connected with the superior cerebellar artery. The region of the BA proximal to the site of convergence with the PTA was hypoplastic in seven cases and completely absent in two cases. Three cases of primitive hypoglossal artery and 2 cases of primitive proatlantal artery were detected by MRA. The prevalence of primitive hypoglossal artery and primitive proatlantal artery was 0.04% and 0.03% respectively. Two cases of primitive hypoglossal artery were from the lateral internal carotid artery and one was from the external carotid artery. It＇s all on the right side. One case of primitive proatlantal artery was on the left which arises from the external carotid artery, one on the right which originated from the outer part of the internal carotid artery. Thirty-four cases were coexisted with other variants of head and neck vessels. All of the primitive hypoglossal arteries were coexisted with vertebral artery absence. One case of primitive proatlantal intersegmental artery was coexisted with vertebral artery dysplasia. Eighteen cases were associate

关 键 词：磁共振成像 原始三叉动脉 原始舌下动脉 原始寰前节间动脉 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]