基于MRA的单侧永存三叉动脉患者发生近心段基底动脉发育不全的影响因素分析  

Analysis of influencing factors of proximal basilar artery hypoplasia in patients with unilateral persistent trigeminal artery based on MRA

作　　者：王玉红[1] 胡哲 赵鲁平 孔维惠[1] 刘乔璐 于昊 刘晓龙 陈月芹[1] Wang Yuhong;Hu Zhe;Zhao Luping;Kong Weihui;Liu Qiaolu;Yu Hao;Liu Xiaolong;Chen Yueqin(Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,China;College of Clinical Medicine,Jining Medical University,Jining 272013,China)

机构地区：[1]济宁医学院附属医院医学影像科,济宁272029 [2]济宁医学院临床医学院,济宁272013

出　　处：《中华解剖与临床杂志》2024年第8期521-526,共6页Chinese Journal of Anatomy and Clinics

基　　金：山东省自然科学基金(ZR2021MH109)。

摘　　要：目的:探讨单侧永存三叉动脉(PTA)患者发生近心段基底动脉发育不全(BAH)的影响因素。方法:横断面研究。纳入2021年1月—2023年12月在济宁医学院附属医院医学影像科行颅脑磁共振血管成像(MRA)检查的单侧Weon 1~4型PTA患者176例,其中男65例、女111例,年龄6~84(57.5±12.9)岁。患者均接受颅脑三维时间飞跃法MAR扫描,MRA图像使用容积重现、最大密度投影等技术进行图像后处理。观察指标:(1)PTA Salas分型和Weon分型情况;(2)测量PTA起始处及其汇入基底动脉处的直径、汇入点近心段和远心段基底动脉的直径,以及PTA汇入基底动脉处至小脑上动脉间的距离;(3)按照近心段基底动脉直径,将患者分为无BAH(non-BAH)组(近心段基底动脉直径≥2 mm)和BAH组(近心段基底动脉直径<2 mm),单因素分析比较2组患者的基线资料性别、年龄、Weon分型、Salas分型、侧别,以及影像学参数远心段基底动脉直径、PTA汇入基底动脉处直径、PTA起始处直径、PTA汇入基底动脉处至小脑上动脉距离,对P<0.05的因素纳入多因素logistic回归分析,筛选PTA患者发生近心段BAH的影响因素;(4)采用logistic拟合曲线观察PTA汇入基底动脉处直径与BAH的关系。结果:176例PTA患者中,Salas分型外侧型157例、内侧型19例,Weon分型1型113例、2型14例、3型30例、4型19例。BAH组(83例)与non-BAH组(93例)患者性别、年龄、侧别、Salas分型、PTA起始处直径、PTA汇入基底动脉处至小脑上动脉距离等差异均无统计学意义(P值均>0.05)。BAH组的PTA汇入基底动脉处直径为(2.9±0.6)mm,大于non-BAH组的(2.5±0.6)mm;远心段基底动脉直径为(3.1±0.6)mm,小于non-BAH组的(3.4±0.5)mm;non-BAH组Weon分型1型65例、2型2例、3型16例、4型10例,BAH组Weon分型1型48例、2型12例、3型14例、4型9例:组间比较差异均有统计学意义(t=16.03、18.71,χ^(2)=9.35,P值均<0.05),单因素分析结果表明,PTA汇入基底动脉处直径、远Objective This study aimed to evaluate the influencing factors of proximal basilar artery hypoplasia(BAH)in patients with unilateral persistent trigeminal artery(PTA)on the basis of magnetic resonance angiography(MRA).Methods The cross-sectional study was conducted.A total of 176 patients diagnosed with unilateral Weon 1-4 type PTA,undergoing MRA in the Department of Medical Imaging of Affiliated Hospital of Jining Medical University during January 2021 and December 2023,were included,comprising 65 males and 111 females with an age range of 6-84 years(mean age:57.5±12.9 years).All patients underwent MRA scanning with 3D time of flight method.MRA data were post-processed using techniques such as volume rendering and maximum intensity projection.(1)PTA classifications were observed.(2)The PTA diameters at the origin and confluence with basilar artery,the diameter of proximal and distal segments of basilar artery at the entry point,and the distance between PTA confluence with basilar artery and superior cerebellar artery were measured.(3)Patients were divided into non-BAH group and BAH group on the basis of proximal basilar artery diameter(≥2 mm vs.<2 mm)to assess proximal basilar artery development.The clinical and radiological differences between the two groups were compared,and factors,such as gender,age,Weon classification,Salas classification,laterality,diameter of distal segment of basilar artery,PTA diameter at the confluence and the origin,and distance between PTA confluence and superior cerebellar artery,were analyzed using univariate logistic regression with statistically significant differences(P<0.05)and multivariate logistic regression to explore their correlation with proximal BAH.(4)logistic fitting curve was used to observe the relationship between the diameter of PTA into the basilar artery and BAH.Results Among the 176 patients with unilateral Weon 1-4 type PTA,Salas classifications showed 157 cases of lateral type and 19 cases of medial type.Weon classifications included 113 cases of type 1,14

关 键 词：血管畸形 永存三叉动脉 基底动脉发育不全 磁共振血管成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]