基于DSA的前循环动脉干形态镜像性的观察  

Observation of morphological mirroring of anterior circulation trunk based on DSA

作　　者：刘文虎[1] 张立功[1] 赵炳一 高宗恩[1] LIU Wenhu;ZHANG Ligong;ZAO Bingyi;GAO Zongen(Department of Neurology,Shengli Oilfield Central Hospital,Dongying,Shandong Province 257000,China)

机构地区：[1]胜利油田中心医院神经内科,山东东营2570000 [2]胜利油田中心医院神经介入手术室,山东东营2570000

出　　处：《介入放射学杂志》2024年第5期472-478,共7页Journal of Interventional Radiology

摘　　要：目的探讨基于DSA的前循环动脉干的形态镜像性,分析前循环大动脉闭塞血管内治疗时参考健侧动脉走行进行导丝探查的价值。方法纳入2021年1月至2022年8月在胜利油田中心医院行脑血管造影术患者250例(造影组),分为3组:青年造影组(年龄<50岁),中年造影组(50~69岁),老年造影组(年龄≥70岁);另选行急诊机械取栓治疗的急性前循环大血管闭塞患者170例(取栓组)。观察造影组与取栓组(责任血管成功开通后)患者的脑血管造影影像资料,分析造影组双侧颈内动脉C1段、C2-C3段、虹吸段、大脑中动脉M1分叉前段以及分叉后段走行的镜像性情况,并分析取栓组血管开通率、双侧走行一致率。结果造影组双侧颈内动脉C1段、C2-C3段、虹吸段、M1分叉前段、M1分叉后段走行差异均无统计学意义(均P>0.05),M1分叉前段双侧镜像性一般,其余各段均双侧镜像性良好,青年造影组、中年造影组、老年造影组双侧颈内动脉C1段、C2-C3段、虹吸段、M1分叉前段、M1分叉后段走行差异均无统计学意义(均P>0.05),青年造影组C1段、各组M1分叉前段双侧镜像性一般,其余各分段双侧镜像性良好;取栓组闭塞血管开通率95.5%,全组双侧走行一致率89.0%。结论双侧颈内动脉C1段、C2-C3段、虹吸段、大脑中动脉M1分叉前段、分叉后段走行均存在镜像性,为脑动脉机械取栓和大动脉慢性闭塞开通时参照病变对侧血管走行操控血管内治疗材料提供了依据。Objective To explore the morphological symmetry of the anterior circulation cerebral arteries based on digital subtraction angiography(DSA), and to analyze the value of arterial walking route on the healthy side in guiding catheterization in endovascular treatment for patients with sick-side major artery occlusion of the anterior circulation. Methods A total of 250 consecutive patients who underwent cerebral angiography at the Shengli Oilfield Central Hospital of China between January 2021 and August 2022 were enrolled in this study as angiography group, which was subdivided into youth angiography subgroup(<50 years),middle-aged angiography subgroup(50-69 years), and elderly angiography subgroup(≥70 years). Other 170patients with acute occlusion of the anterior circulation vessels, who received emergency mechanical thrombectomy,were collected as thrombectomy group. After successful recanalization, the cerebral angiographic imaging findings of both groups, including the arterial walking route symmetry of bilateral C1 segment, C2-C3 segment,ophthalmic segment, M1 segment proximal to the bifurcation, and M1 segment distal to the bifurcation, were analyzed and compared between the two groups. The recanalization rate and the consistency of bilateral arterial walking route in the thrombectomy group were also analyzed. Results No statistically significant differences in the arterial walking route of the C1 segment, C2-C3 segment, ophthalmic segment, M1 segment proximal to the bifurcation, and M1 segment distal to the bifurcation existed between the left side and right side(all P>0.05). Ordinary bilateral symmetry was observed in M1 segment proximal to the bifurcation, and excellent bilateral symmetry was observed in all the other segments. There were no statistically significant differences in the bilateral arterial walking route of the C1 segment, C2-C3 segment, ophthalmic segment, M1 segment proximal to the bifurcation, and M1 segment distal to the bifurcation between each other among the three subgroups(all P>0.05)

关 键 词：前循环动脉 镜像性 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]