颈部CT血管成像联合经颅多普勒超声在椎动脉型颈椎病评价中的应用  

Application of neck computed tomography angiography and transcranial Doppler ultrasound in the evaluation of vertebral artery type cervical spondylosis

作　　者：叶芮研 吴安琪 钱琦[2] 林敏[3] Ye Ruiyan;Wu Anqi;Qian Qi;Lin Min(The Third Clinical College of Zhejiang Chinese Medical University,Hangzhou 310053,China;The Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310009,China;Zhejiang Chinese Medical University,Hangzhou 310005,China)

机构地区：[1]浙江中医药大学第三临床医学院,杭州310053 [2]浙江中医药大学附属第三医院,杭州310009 [3]浙江中医药大学,杭州310005

出　　处：《心脑血管病防治》2023年第11期32-34,38,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省中医药现代化专项项目(2021ZX011)。

摘　　要：目的对比分析颈部CT血管成像(CTA)及经颅多普勒超声(TCD)在椎动脉型颈椎病评价中的应用价值及影像学表现。方法对2016年1月至2022年10月就诊于浙江中医药大学附属第三医院经TCD和CTA检查确认为椎动脉型颈椎病的79例患者进行资料收集,记录两种检查的各项测量指标,并进行统计学分析。结果158支椎动脉中CTA检出140支有形态学异常,异常率88.6%,以椎动脉迂曲及椎动脉纤细变异居多;TCD检出129支椎动脉存在流速异常,流速异常率81.6%,以低流速表现为主;椎动脉异常形态学改变的血管流速异常率较椎动脉无异常形态学改变的血管流速异常率高,差异具有统计学意义(χ^(2)=62.235,P<0.01)。结论颈椎退变合并椎动脉形态学改变引起血流动力学失衡可能与椎动脉型颈椎病发病相关,CTA及TCD对于评估椎动脉型颈椎病具有重要价值。Objective To compare and analyze the application value and imaging findings of neck computed tomography angiography(CTA)and transcranial Doppler ultrasound(TCD)in the evaluation of vertebral artery type cervical spondylosis.Methods Data were collected from 79 patients diagnosed with vertebral artery type cervical spondylosis through TCD and CTA examinations at the Third Affiliated Hospital of Zhejiang Chinese Medical University from January 2016 to October 2022.Various measurement indexes from both examinations were recorded and subjected to statistical analysis.Results Among 158 vertebral arteries,CTA detected morphological abnormalities in 140 arteries,with an abnormality rate of 88.6%,primarily characterized by vertebral artery tortuosity and slender vertebral arteries.TCD identified abnormal flow velocity in 129 vertebral arteries,resulting in an abnormality rate of 81.6%,mainly manifested as reduced flow velocity.The arteries with vertebral artery morphological abnormalities had a significantly higher rate of flow velocity abnormalities than the arteries without vertebral artery morphological abnormalities,the difference was statistically significant(χ^(2)=62.235,P<0.01).Conclusion Cervical spondylosis with vertebral artery morphological changes leading to hemodynamic imbalance may be associated with the development of vertebral artery type cervical spondylosis.Both CTA and TCD have important value in the evaluation of vertebral artery type cervical spondylosis.

关 键 词：椎动脉型颈椎病 椎动脉供血不足 经颅多普勒超声 颈部CT血管成像 

分 类 号：R681.5[医药卫生—骨科学] R816.8[医药卫生—外科学]