老年脑动脉狭窄患者胚胎型大脑后动脉与侧支循环的相关性研究  

Relationship between FTP cerebral artery circulation and collateral circulation in elderly cerebral artery stenosis patients

作　　者：张敬艳[1] 刘明浩 杨超 朱磊 王佳楠 郭姗姗 黄玲 Zhang Jingyan;Liu Minghao;Yang Chao;Zhu Lei;Wang Jianan;Guo Shanshan;Huang Ling(Department of Neurology,Second Affiliated Hospital of Qiqihar Medical University,Qiqihar 161006,Heilongjiang Province,China)

机构地区：[1]齐齐哈尔医学院附属第二医院神经内六科,161006 [2]火箭军特色医学中心涉核人员治疗科

出　　处：《中华老年心脑血管病杂志》2021年第11期1129-1132,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：黑龙江省省属高等学校基本科研项目(2020-KYYWF-0026)。

摘　　要：目的研究老年脑动脉狭窄患者胚胎型大脑后动脉(FTP)与侧支循环的相关性。方法选择2019年1月~2021年3月火箭军特色医学中心神经内科和齐齐哈尔医学院附属第二医院神经内六科诊治的存在FTP和脑动脉狭窄的老年患者45例。评估FTP的影像学特点,分析合并脑动脉狭窄或闭塞时FTP与侧支循环的相互关系。结果完全型FTP(cFTP)20例(44.44%),其中双侧cFTP 11例,1侧cFTP 9例;部分型FTP(pFTP)17例(37.78%),其中双侧pFTP 3例,1侧pFTP 14例;1侧pFTP另1侧cFTP 8例(17.78%)。pFTP合并同侧颈内动脉狭窄且P1段管径<后交通动脉管径时,不能建立由后循环-右侧后交通动脉-右侧前循环的有效代偿;cFTP合并同侧大脑前动脉闭塞且P1段管径=后交通动脉管径时,可建立颈内动脉-后交通动脉-P1段-大脑后动脉-大脑前动脉软脑膜吻合侧支代偿;FTP合并椎基底动脉闭塞时,可建立颈内动脉-大脑后动脉代偿,颈内动脉-后交通动脉-P1段-双侧小脑上动脉侧支代偿,不能建立颈内动脉-基底动脉分支(除大脑后动脉和双侧小脑上动脉)的有效代偿。结论FTP合并脑动脉狭窄时改变了常规状态下的脑动脉侧支循环途径,pFTP可建立前后循环之间的侧支循环代偿,代偿能力取决于P1段的管径。Objective To study the relationship between fetal-type posterior(FTP)cerebral artery circulation and collateral circulation in elderly cerebral artery stenosis patients.Methods Forty-five elderly patients with FTP cerebral artery circulation and cerebral artery stenosis in Characteristic Medical Center of Chinese PLA Rocket Force and Second Affiliated Hospital of Qiqihar Medical University from January 2019 to March 2021 were included in this study.Their general clinical and imaging data were recorded and their imaging characteristics of FTP cerebral artery circulation were assessed.The relationship between FTP cerebral artery circulation and collateral circulation in cerebral artery stenosis or occlusion patients was analyzed.Results The cFTP cerebral artery circulation was detected in 20 patients(44.44%),including bilateral cFTP in 11 and unilateral cFTP in 9.pFTP was detected in 17 patients(37.78%),including bilateral pFTP in 3 and unilateral pFTP in 14.One side pFTP and other side cFTP were detected in 8 patients(17.78%).Effective compensation from rear circulation to right PCoA circulation and right anterior circulation could not be established when the partial FTP cerebral artery circulation was complicated with the same side internal carotid artery(ICA)stenosis and P1 diameter was<PCoA diameter,and could be established from ICA circulation to PCoA and ACA leptomeningeal anastomotic collateral circulation when the complete FTP cerebral artery circulation was complicated with ACA occlusion and P1 diameter was equal to PCoA diameter.Effective compensation from ICA-PCA circulation to ICA-PCoA circulation and PCoA-P1 bilateral upper cerebellar artery lateral circulation could be established when the FTP cerebral artery circulation was complicated with vertebral basal artery occlusion,and could not be establish for the ICA-basal artery circulation(except posterior cerebral artery circulation and bilateral upper cerebellum artery circulation).ConclusionFTP cerebral artery circulation with cerebral artery stenosis

关 键 词：脑动脉疾病 大脑后动脉 侧支循环 计算机体层摄影血管造影术 磁共振血管造影术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]