CAJ | 학술논문

目的：：探讨椎-基底动脉迂曲及迂曲程度与后循环缺血( posterior circulation ischemia,PCI)之间的关系。方法：回顾性分析了205例行头颅容积CT数字减影血管成像( volume computed tomographic digital subtraction angiography,VCTDSA)检查的后循环缺血患者( PCI组)和108名无前后循环缺血临床表现的正常人。在VR图像上观察椎动脉颅内段和基底动脉是否有迂曲,并分别测量每个迂曲的角度。根据迂曲数量和迂曲角度对双侧椎动脉及基底动脉迂曲程度行迂曲评级。椎-基底动脉迂曲程度与PCI行相关性分析。结果：(1)对照组和PCI组的左右侧椎动脉颅内段及基底动脉迂曲的发生率均有显著性差异(χ2=66.860,P=0.000；χ2=43.457,P=0.000；χ2=19.203,P=0.000)。(2)PCI 组,左右椎动脉及基底动脉迂曲程度≥Ⅲ级者显著高于对照组(χ2=91.115,P=0.000；χ2=86.620,P=0.000；χ2=43.371,P=0.000)。(3)椎动脉颅内段走行迂曲与PCI相关(r=0.49,P=0.000)；椎动脉颅内段迂曲程度≥Ⅲ级与PCI中等强度相关(r=0.65,P=0.000)。基底动脉走行迂曲与PCI相关(r=0.25,P=0.000)；基底动脉颅内段迂曲程度≥Ⅲ级与PCI相关(r=0.37,P=0.000)。结论：椎动脉颅内段和基底动脉走行迂曲可能引起PCI,尤其是当椎动脉迂曲程度达到Ⅲ级以上的情况。
목적：：탐토추-기저동맥우곡급우곡정도여후순배결혈( posterior circulation ischemia,PCI)지간적관계。방법：회고성분석료205례행두로용적CT수자감영혈관성상( volume computed tomographic digital subtraction angiography,VCTDSA)검사적후순배결혈환자( PCI조)화108명무전후순배결혈림상표현적정상인。재VR도상상관찰추동맥로내단화기저동맥시부유우곡,병분별측량매개우곡적각도。근거우곡수량화우곡각도대쌍측추동맥급기저동맥우곡정도행우곡평급。추-기저동맥우곡정도여PCI행상관성분석。결과：(1)대조조화PCI조적좌우측추동맥로내단급기저동맥우곡적발생솔균유현저성차이(χ2=66.860,P=0.000；χ2=43.457,P=0.000；χ2=19.203,P=0.000)。(2)PCI 조,좌우추동맥급기저동맥우곡정도≥Ⅲ급자현저고우대조조(χ2=91.115,P=0.000；χ2=86.620,P=0.000；χ2=43.371,P=0.000)。(3)추동맥로내단주행우곡여PCI상관(r=0.49,P=0.000)；추동맥로내단우곡정도≥Ⅲ급여PCI중등강도상관(r=0.65,P=0.000)。기저동맥주행우곡여PCI상관(r=0.25,P=0.000)；기저동맥로내단우곡정도≥Ⅲ급여PCI상관(r=0.37,P=0.000)。결론：추동맥로내단화기저동맥주행우곡가능인기PCI,우기시당추동맥우곡정도체도Ⅲ급이상적정황。
Objective:To investigate the relationship between posterior circulation ischemia ( PCI) and circuity and tortuosity degree of vertebrobasilar artery. Methods:A total of 205 patients with posterior circulation ischemia were included. An additional 108 subjects were concomitantly enrolled as controls. We investigated by using VCTDSA in all subjects. First,the circuity of vertebrobasilar arteries were observed and angle of these circuity were measured on VR images in both group. Then,according to numbers and angle of tortuosity,tortuosity degrees were estimated. Finally,the correlation between circuity degrees of vertebral-basilar artery and PCI were an-alyzed. Results:Significant differences of the incidence of left and right vertebral artery and basilar artery were found between patients with PCI and controls (χ2 =66. 860,P P=0. 000;χ2 =43. 457,P=0. 000;χ2 =19. 203,P=0. 000). The circuity degrees in PCI was significantly higher than that in controls,showing a significant difference (χ2 =91. 115,P=0. 000;χ2 =86. 620,P=0. 000;χ2 =43. 371,P=0. 000). PCI has correlation with the circuity of vertebral artery (r=0. 49,P=0. 000). There is a moderate correlation be-tween circuity level Ⅲor higher of vertebral artery and PCI (r=0. 65,P=0. 000). PCI has correlation with the circuity of basal artery (r=0. 25,P=0. 000). There is a weak correlation between circuity level Ⅲ or higher of basal artery and PCI(r=0. 37,P=0. 000). Conclusion:The circuity of vertebrobasilar arteries may lead to PCI,especially circuity level Ⅲ or higher.