不明原因孤立性眩晕患者MR椎基底动脉形态及脑灌注探讨  

Assessment of the vertebrobasilar artery morphology and cerebral perfusion in patients with undetermined isolated vertigo

作　　者：吴伟烽 游荣娇 余青云[1] 彭忠兴[1] 洪铭范[1] 刘爱群[1] WU Weifeng;YOU Rongjiao;YU Qingyun;PENG Zhongxing;HONG Mingfan;LIU Aiqun(Department of Neurology,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院神经内科,广东广州510080

出　　处：《广东药科大学学报》2021年第4期101-106,共6页Journal of Guangdong Pharmaceutical University

基　　金：广东省医学科学技术研究基金项目(A2018426);广东省中医药局科研项目(20181155)。

摘　　要：目的探讨不明原因孤立性眩晕(undetermined isolated vertigo,UIV)椎基底动脉形态和脑灌注情况。方法采用前瞻性研究,纳入26例UIV患者作为试验组,16例良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者作为BPPV组,14例健康体检者作为正常对照组。行MR检查评估椎基底动脉形态和脑灌注。结果UIV组高血压、高血脂、脑血管危险因素≥3个更常见(P<0.05)。UIV组椎动脉优势(vertebral artery dominance,VAD)发生率最高(P<0.05),基底动脉弯曲长度(bending length,BL)最长(P<0.05)。UIV组小脑灌注的平均通过时间(mean transit time,MTT)、达峰时间(time to peak,TTP)以及脑干灌注的TTP较其他两组延长(P<0.05)。存在基底动脉弯曲(basilar artery curvature,BAC)的UIV患者脑干的MTT比非BAC患者延长(P<0.05)。结论UIV的发生与椎基底动脉形态异常和后循环低灌注有关。Objective To assess the vertebrobasilar artery morphology and cerebral perfusion in patients with undetermined isolated vertigo(UIV).Methods A prospective study was performed.Twenty patients with UIV were recruited as vertigo group,16 patients with benign paroxysmal positional vertigo(BPPV)were recruited as BPPV group,and 14 healthy subjects were recruited as the normal group.The 3.0 T cranial magnetic resonance imaging(MRI)was performed to evaluate the morphology of vertebrobasilar artery and cerebral perfusion.Results In UIV group,the hypertension,hyperlipidemia and cerebrovascular risk factors≥3 were more commonly(P<0.05).The UIV group had the highest incidence of vertebral artery dominance(VAD)(P<0.05),and the longest basilar artery bending length(BL)(P<0.05).Compared with the other two groups,the mean transit time(MTT),the time to peak(TTP)of cerebellum and the TTP of cerebral stem in UIV group were significantly delayed(P<0.05).The MTT of brainstem in UIV patients with basilar artery curvature(BAC)was significantly delayed compared with that of non-BAC patients(P<0.05).Conclusion The abnormal vertebrobasilar artery morphology and posterior circulation hypoperfusion are related to the occurrence of UIV.

关 键 词：孤立性眩晕 磁共振 危险因素 椎基底动脉 脑灌注 

分 类 号：R743.1[医药卫生—神经病学与精神病学]