颅内动脉开窗畸形与动脉瘤及蛛网膜下腔出血相关性分析  

Relationship between cerebral arterial fenestrations and subarachnoid hemorrhage

作　　者：王辰龙 周红[1] 呼群 张瑞云 张海廷 李志方[2] WANG Chen-long;ZHOU Hong;HU Qun;ZHANG Rui-yun;ZHANG Hai-ting;LI Zhi-fang(Department of Neurology,Civil Aviation General Hospital,Beijing 100123,China;Academy of Military Medical Sciences,PLA,Beijing 100039,China)

机构地区：[1]民航总医院(北京大学民航临床医学院)神经内科,北京100123 [2]中国人民解放军军事医学科学院,北京100039

出　　处：《中国临床医学影像杂志》2021年第4期229-232,共4页Journal of China Clinic Medical Imaging

基　　金：北京市自然科学基金(7172156)。

摘　　要：目的:探讨颅内动脉开窗的影像学特点及其与动脉瘤、蛛网膜下腔出血的关系。方法:回顾性连续纳入2014年10月—2017年12月于民航总医院完善颅内动脉影像学检查(含CTA及MRA)并确诊为颅内动脉开窗畸形的126例患者,分析其影像学资料,记录开窗部位、是否合并动脉瘤;同时回顾临床资料或头部CT和/或MRI明确有无蛛网膜下腔出血。结果:126例患者中,前循环系统21例(16.7%),其中大脑前动脉16例(12.7%),大脑中动脉2例(1.6%),前交通动脉3例(2.4%);后循环系统105例(83.3%),其中大脑后动脉2例(1.6%),基底动脉91例(72.2%),椎动脉12例(9.5%)。7例患者合并动脉瘤,其中1例前交通动脉开窗畸形局部合并1个动脉瘤,其余6例开窗畸形位于基底动脉近端。裂隙型41例(32.5%),凸透镜型68例(54.0%),重复型17例(13.5%)。血管开窗长度≤5 mm 84例(66.7%),>5~10 mm 38例(30.2%),>10 mm 4例(3.2%)。开窗畸形均未合并蛛网膜下腔出血。随访1年,患者未出现新发脑出血或蛛网膜下腔出血事件。结论:颅内动脉开窗畸形以基底动脉开窗最为常见,开窗畸形局部合并动脉瘤发生率低,与蛛网膜下腔出血无相关性。Objective:To investigate the imaging features of cerebral arterial fenestrations,and the relationships with aneurysm and subarachnoid hemorrhage.Methods:A retrospective study of 126 patients who underwent intracranial arterial imaging(including CTA and MRA)and confirmed intracranial artery fenestration in Civil Aviation General Hospital from October 2014 to December 2017,and analyzed their imaging findings.Data,record the window opening,whether the aneurysm was combined;and clinical data or head CT and/or MRI were reviewed to determine whether there was subarachnoid hemorrhage.Results:Of the 126 patients,21 cases(16.7%)had fenestration in the anterior circulation system,including 16 cases(12.7%)of anterior cerebral artery,2 cases(1.6%)of middle cerebral artery,3 cases(2.4%)of anterior communicating artery;105 cases(83.3%)had fenestration in the posterior circulation system,there were 2 cases(1.6%)of posterior cerebral artery,91 cases(72.2%)of basilar artery,and 12 cases(9.5%)of vertebral artery.Seven patients had aneurysms.One of the anterior communicating artery fenestrations combined with one local aneurysm,and the other six fenestrations were located at the proximal end of the basilar artery.There were 41 cases(32.5%)with fissure type,68 cases(54.0%)with convex lens type,and 17 cases(13.5%)with repeat type.The length of the vascular window≤5 mm 84 cases(66.7%),>5~10 mm 38 cases(30.2%),>10 mm 4 cases(3.2%).There was no subarachnoid hemorrhage in the fenestration.After 1 year of follow-up,there were no new cerebral hemorrhage or subarachnoid hemorrhage.Conclusion:The intracranial artery fenestration is the most common with basilar artery fenestration.The incidence of fenestration and local aneurysm is low,and there is no correlation with subarachnoid hemorrhage.

关 键 词：颅内动静脉畸形 颅内动脉瘤 蛛网膜下腔出血 磁共振血管造影术 计算机体层摄影血管造影术 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R743.35[医药卫生—临床医学]