CAJ | 학술논문

目的：探讨椎基底动脉变异的种类和发生率及DSA影像学特征，提高对椎基底动脉变异临床意义的认识。方法对6432例患者均进行全脑血管进行造影，对全脑血管造影的DSA图像资料进行回顾性分析，得出椎基底动脉变异的发生率及变异血管合并其他血管病变的情况。结果发生椎动脉起源变异272例患者278支椎动脉，检出率为4.3％，其中左椎动脉起源异常270支（4．2％），右椎动脉起源异常8支；左椎动脉起源异常中，258支直接起自主动脉弓，2例为双起源椎动脉，4支起自颈内动脉，6支起自左锁骨下动脉根部。8支右椎动脉起源异常中，2支直接起源于右颈总动脉，2支起自右颈内动脉动脉，2例为双起源椎动脉，2支直接起自头臂干动脉。141例椎基底动脉成窗（2．19％）；61支小脑后下动脉起自颅外段位置较低部位。11例永久性原始三叉动脉。另外，有9例变异结构的远端或近端伴发动脉瘤、2例伴发动静脉畸形。7例出现与成窗结构供血区相一致的一过性脑缺血症状，其中2例出现经成窗结构远端供血部位的脑梗塞，1例出现经双起源椎动脉供血部位的脑梗塞。结论脑血管DSA可以清晰显示椎基底动脉变异的位置、形态、毗邻关系及有无伴发其他血管性病变；掌握椎基底动脉变异的DSA影像学表现及血流动力学特征，对脑血管病的明确诊断及手术和介入治疗方案的制定具有重要临床意义。
목적：탐토추기저동맥변이적충류화발생솔급DSA영상학특정，제고대추기저동맥변이림상의의적인식。방법대6432례환자균진행전뇌혈관진행조영，대전뇌혈관조영적DSA도상자료진행회고성분석，득출추기저동맥변이적발생솔급변이혈관합병기타혈관병변적정황。결과발생추동맥기원변이272례환자278지추동맥，검출솔위4.3％，기중좌추동맥기원이상270지（4．2％），우추동맥기원이상8지；좌추동맥기원이상중，258지직접기자주동맥궁，2례위쌍기원추동맥，4지기자경내동맥，6지기자좌쇄골하동맥근부。8지우추동맥기원이상중，2지직접기원우우경총동맥，2지기자우경내동맥동맥，2례위쌍기원추동맥，2지직접기자두비간동맥。141례추기저동맥성창（2．19％）；61지소뇌후하동맥기자로외단위치교저부위。11례영구성원시삼차동맥。령외，유9례변이결구적원단혹근단반발동맥류、2례반발동정맥기형。7례출현여성창결구공혈구상일치적일과성뇌결혈증상，기중2례출현경성창결구원단공혈부위적뇌경새，1례출현경쌍기원추동맥공혈부위적뇌경새。결론뇌혈관DSA가이청석현시추기저동맥변이적위치、형태、비린관계급유무반발기타혈관성병변；장악추기저동맥변이적DSA영상학표현급혈류동역학특정，대뇌혈관병적명학진단급수술화개입치료방안적제정구유중요림상의의。
Objective This study is to investigate the prevalence of vertebral basilar artery veriation and its imaging char-acters in patients receiving cerebral artery digital subtraction angiography .Methods We reviewed 6432 patients receiving cerebral artery digital subtraction angiography ,and got the prevalence of vertebral basilar artery veriation and associated cerebral artery diseases in these patients .Results Among the 6432 patients ,4 .2% (278 vertebral arteries in 272 cases) was diagnosed with anomalous origin of vertebral artery ,including 4 .2% of anomalous origin of the left vertebral artery (n=270 ,of which 258 vertebral arteries originated from the aortic arch ,2 cases were duplicitous origin of the left vertebral artery ,4 cases of vertebral artery originated from left internal carotid artery and 6 vertebral arteries originated from the root of left subclavian artery ) and 8 were anomalous origin of the right vertebral artery (of which 2 branches originated from right common carotid artery ,2 originated from right internal artery ,2 duplicitous origin of the right vertebral artery , 2 originated from brachiocephalic trunk ) .61 branches of PCA originated from infraversion .The fenestrations of vertebral basilar artery were 141 cases (2 .19% ) .Persistent trigeminal artery were 11 cases (0 .17% ) .Among the fenestrations of cerebral artery ,9 cases were accompanied with aneurysms ,2 cases were accompanied with arteriovenous malformation .7 cases were accompanied with cerebral ischemia ,2 cases accompanied with cerebral infarction .1 case of duplicitous origin of the right vertebral artery was accompanied with cerebral infarction .Conclusion Cerebral artery digital subtraction angi-ography was able to show the location ,morphology ,adjacent relationship and associated vascular diseases in vertebral bas-ilar artery fenestration .This could provide more information for the diagnosis and treatment of cerebrovascular diseases , especially for the neuroradiology intervention therapy .