临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
3期
301-303,304
,共4页
杨飞%朱晓龙%陈静%朱月香%崔书君
楊飛%硃曉龍%陳靜%硃月香%崔書君
양비%주효룡%진정%주월향%최서군
椎底动脉供血不足%体层摄影术,螺旋计算机%血管造影术%老年人
椎底動脈供血不足%體層攝影術,螺鏇計算機%血管造影術%老年人
추저동맥공혈불족%체층섭영술,라선계산궤%혈관조영술%노년인
vertebrobasilar insufficiency%tomography,spiral computed%angiography%aged people
目的：探讨多排螺旋CT平扫联合CT血管成像（CTA）对诊断老年椎基底动脉延长扩张症（VBD）的应用价值，为临床早期预防及治疗提供参考依据。方法收集就诊于本院经临床及影像学检查诊断为 VBD的患者，分析总结CT平扫及CTA资料、临床资料，将 VBD患者分为老年组及非老年组，分析比较两组间临床表现、影像学表现及后循环脑梗死的发生率。结果 CTA明确诊断为 VBD患者13例，CT平扫可明确诊断为 VBD 10例，CT平扫对VBD诊断的阳性率76．9％（10／13）。CT平扫同时还可发现颅内其他病变。基底动脉测量的直径 CT平扫较 CTA测量结果稍偏大。CTA可清楚显示动脉扩张、迂曲、延长及偏移的情况及程度，可直接测量扩张血管长度、直径。老年组基底动脉（BA）直径、椎动脉（VA）直径、BA高度评分、BA水平移位评分均高于非老年组。老年组脑干压迫征1例，后循环脑梗死2例。结论 CT平扫对 VBD诊断具有较高的阳性率，可作为 VBD的影像学筛查方法之一。CTA是一种有效的诊断 VBD的检查技术。CT平扫联合CTA为临床诊断和治疗 VBD 提供可靠的影像学依据。VBD在老年人中发病率较高，与后循环梗死有关。
目的：探討多排螺鏇CT平掃聯閤CT血管成像（CTA）對診斷老年椎基底動脈延長擴張癥（VBD）的應用價值，為臨床早期預防及治療提供參攷依據。方法收集就診于本院經臨床及影像學檢查診斷為 VBD的患者，分析總結CT平掃及CTA資料、臨床資料，將 VBD患者分為老年組及非老年組，分析比較兩組間臨床錶現、影像學錶現及後循環腦梗死的髮生率。結果 CTA明確診斷為 VBD患者13例，CT平掃可明確診斷為 VBD 10例，CT平掃對VBD診斷的暘性率76．9％（10／13）。CT平掃同時還可髮現顱內其他病變。基底動脈測量的直徑 CT平掃較 CTA測量結果稍偏大。CTA可清楚顯示動脈擴張、迂麯、延長及偏移的情況及程度，可直接測量擴張血管長度、直徑。老年組基底動脈（BA）直徑、椎動脈（VA）直徑、BA高度評分、BA水平移位評分均高于非老年組。老年組腦榦壓迫徵1例，後循環腦梗死2例。結論 CT平掃對 VBD診斷具有較高的暘性率，可作為 VBD的影像學篩查方法之一。CTA是一種有效的診斷 VBD的檢查技術。CT平掃聯閤CTA為臨床診斷和治療 VBD 提供可靠的影像學依據。VBD在老年人中髮病率較高，與後循環梗死有關。
목적：탐토다배라선CT평소연합CT혈관성상（CTA）대진단노년추기저동맥연장확장증（VBD）적응용개치，위림상조기예방급치료제공삼고의거。방법수집취진우본원경림상급영상학검사진단위 VBD적환자，분석총결CT평소급CTA자료、림상자료，장 VBD환자분위노년조급비노년조，분석비교량조간림상표현、영상학표현급후순배뇌경사적발생솔。결과 CTA명학진단위 VBD환자13례，CT평소가명학진단위 VBD 10례，CT평소대VBD진단적양성솔76．9％（10／13）。CT평소동시환가발현로내기타병변。기저동맥측량적직경 CT평소교 CTA측량결과초편대。CTA가청초현시동맥확장、우곡、연장급편이적정황급정도，가직접측량확장혈관장도、직경。노년조기저동맥（BA）직경、추동맥（VA）직경、BA고도평분、BA수평이위평분균고우비노년조。노년조뇌간압박정1례，후순배뇌경사2례。결론 CT평소대 VBD진단구유교고적양성솔，가작위 VBD적영상학사사방법지일。CTA시일충유효적진단 VBD적검사기술。CT평소연합CTA위림상진단화치료 VBD 제공가고적영상학의거。VBD재노년인중발병솔교고，여후순배경사유관。
ABSTRACT:Objective To observe the pathogenesis,clinical manifestations and image features of the patients with vertebrobasilar dolichoectasia(VBD)using CT plain scan and multi-slice spiral CT angiography(MSCTA),and to provide some references for the clinical diagnosis and early prevention and treatment of VBD.Methods VBD patients diagnosed with clinical presentations and imaging features in our hospital were enrolled in this study.CT plain scan and MSCTA data as well as clinical data of each patient were analyzed.According to the age,the VBD patients were divided into elderly group and non-elderly group.The clinical manifestations,image findings and the incidence of cerebral infarction in posterior circulation were compared.For all cases,the images were analyzed by two radiologists with double blind method.Results A total of 13 patients with VBD were enrolled,among which 10 cases could be clearly diagnosed by CT plain scan and all of the 1 3 cases diagnosed by MSCTA.The sensitivity of CT plain scan for VBD was 76.9%(10/13).Other intracranial lesions could also be found by CT plain scan at the same time.The diameter of the basilar artery measured by CT plain scan was slightly larger than that measured by MSCTA.MSCTA could also clearly display the expansion,circuity,prolonging,and migration of VBA,so that the length and diameter of the expanded blood vessels could be directly measured.The average VBA diameter,height of BA bifurcation and lateral extent of BA in the elderly group were higher than those of the non-elderly group.There were one patient with brain stem compression and two patients with posterior circulation ischemia in the elderly group.Conclusion CT plain scan is of high sensitivity in the diagnosis of VBD,which can be used as one of the imaging screening methods in the diagnosis of VBD.However,MSCTA is an effective diagnostic technique of VBD.Thus,CT plain scan combined with MSCTA can provide a more reliable basis for the clinical diagnosis and treatment of VBD.The incidence of VBD is higher in the aged people,which is associatied with the posterior circulation infarction.
