CAJ | 학술논문

目的：探讨脑动脉成窗的发生率及DSA影像学特征，提高对脑动脉成窗临床意义的认识。方法对6432例患者进行全脑血管造影，回顾性分析DSA图像资料，得出脑动脉成窗的发生率及成窗血管合并其他血管病变的情况。结果脑动脉开窗283例，296个成窗，发生率为4.60%（296/6432）。其中颈内动脉19例（21个成窗，，检出率为0.33%，左侧9个，右侧12个）；大脑前动脉46例（51个成窗，检出率为0.79%，左侧25个，右侧26个）；大脑中动脉54例（57个成窗，检出率为0.89%，左侧29个，右侧28个）；椎动脉68例（71个成窗，检出率为1.10%，左侧37个，右侧34个）；基底动脉95例（95个成窗，检出率为1.37%）。另外，有17个成窗结构的远端或近端伴发动脉瘤、5个成窗伴发动静脉畸形，37个成窗出现与成窗结构供血区相一致的一过性脑缺血症状，其中6个出现经成窗结构远端供血部位的脑梗死。结论脑血管DSA可以清晰显示脑动脉成窗的位置、形态、毗邻关系及有无伴发其他血管性病变；掌握脑动脉成窗的DSA影像学表现，对脑血管病的明确诊断及手术和介入治疗方案的制订具有重要临床意义。
목적：탐토뇌동맥성창적발생솔급DSA영상학특정，제고대뇌동맥성창림상의의적인식。방법대6432례환자진행전뇌혈관조영，회고성분석DSA도상자료，득출뇌동맥성창적발생솔급성창혈관합병기타혈관병변적정황。결과뇌동맥개창283례，296개성창，발생솔위4.60%（296/6432）。기중경내동맥19례（21개성창，，검출솔위0.33%，좌측9개，우측12개）；대뇌전동맥46례（51개성창，검출솔위0.79%，좌측25개，우측26개）；대뇌중동맥54례（57개성창，검출솔위0.89%，좌측29개，우측28개）；추동맥68례（71개성창，검출솔위1.10%，좌측37개，우측34개）；기저동맥95례（95개성창，검출솔위1.37%）。령외，유17개성창결구적원단혹근단반발동맥류、5개성창반발동정맥기형，37개성창출현여성창결구공혈구상일치적일과성뇌결혈증상，기중6개출현경성창결구원단공혈부위적뇌경사。결론뇌혈관DSA가이청석현시뇌동맥성창적위치、형태、비린관계급유무반발기타혈관성병변；장악뇌동맥성창적DSA영상학표현，대뇌혈관병적명학진단급수술화개입치료방안적제정구유중요림상의의。
Objective To investigate the clinical incidence of cerebral artery fenestration and its digital subtraction angiography (DSA) characteristics in order to improve the understanding of the clinical significance of the cerebral artery fenestration. Methods Whole cerebral angiography with DSA was employed in a total of 6 432 patients. The imaging material was retrospectively analyzed. The incidence of cerebral artery fenestration and the associated cerebral artery diseases were analyzed. Results Among the 6 432 patients, cerebral artery fenestration was detected in 283 with 296 fenestrations in total (4.60%, 296/6 432). The cerebral artery fenestration of internal carotid was seen in 19 cases with 21 fenestrations (9 on the left side and 12 on the right side), and the detection rate was 0.33%. The fenestration of anterior cerebral artery was found in 46 cases with 51 fenestrations (25 on the left side and 26 on the right side), and the detection rate was 0.79%. The fenestration of middle cerebral artery was found in 54 cases with 57 fenestrations (29 on the left side and 28 on the right side), and the detection rate was 0.89%. The fenestration of vertebral artery was revealed in 68 cases with 71 fenestrations (37 on the left side and 34 on the right side), and the detection rate was 1.10%. The fenestration of basilar artery was demonstrated in 95 cases with 95 fenestrations, and the detection rate was 1.37%. Besides, 17 fenestrations were accompanied with aneurysms and 5 fenestrations were complicated by arteriovenous malformations. Transient cerebral ischemia occurred in 37 cases with fenestrations, and ischemic symptoms were consistent with the blood supply region of the fenestration structures. Among the 37 cases , cerebral infarction at the distal region of the fenestration characteristics of the cerebral fenestrations is of great clinical significance for its diagnosis and for the selection of therapeutic scheme.