CAJ | 학술논문

目的：探讨多模式动态影像学诊断椎动脉夹层的临床价值及对治疗的指导意义。方法经多模式动态影像学检查确诊的25例椎动脉夹层患者，其中8例经动态影像学检查观察夹层演变情况。结果颅外段椎动脉夹层 MR 表现为“新月形”壁内血肿，颅内段 MR 表现为瘤样扩张伴血栓形成。颅外段椎动脉夹层 CT 血管造影（CTA）表现为内膜瓣和动脉双腔，颅内段 CTA 表现为瘤样扩张伴腔内血栓及钙化。颅外段椎动脉夹层数字减影血管造影（DSA）表现为动脉狭窄、双腔、内膜瓣，颅内段 DSA 表现为“珠线征”。3例蛛网膜下腔出血（SAH）患者经动态 DSA 检查确诊颅内段椎动脉夹层。5例颅外段椎动脉夹层患者行动态 DSA 观察夹层演变，4例自愈，1例因病变进展行介入治疗。结论多模动态影像学检查可提高椎动脉夹层的早期确诊率，并能动态观察椎动脉夹层演变过程，对临床治疗具有重要的指导意义。
목적：탐토다모식동태영상학진단추동맥협층적림상개치급대치료적지도의의。방법경다모식동태영상학검사학진적25례추동맥협층환자，기중8례경동태영상학검사관찰협층연변정황。결과로외단추동맥협층 MR 표현위“신월형”벽내혈종，로내단 MR 표현위류양확장반혈전형성。로외단추동맥협층 CT 혈관조영（CTA）표현위내막판화동맥쌍강，로내단 CTA 표현위류양확장반강내혈전급개화。로외단추동맥협층수자감영혈관조영（DSA）표현위동맥협착、쌍강、내막판，로내단 DSA 표현위“주선정”。3례주망막하강출혈（SAH）환자경동태 DSA 검사학진로내단추동맥협층。5례로외단추동맥협층환자행동태 DSA 관찰협층연변，4례자유，1례인병변진전행개입치료。결론다모동태영상학검사가제고추동맥협층적조기학진솔，병능동태관찰추동맥협층연변과정，대림상치료구유중요적지도의의。
Objective To explore the clinical value of multimode dynamic imaging in diagnosing and treating ver-tebral artery dissection.Methods A total of 25 patients were diagnosed vertebral artery dissections by multimode dynamic imaging,8 patients of all were diagnosed by dynamic imaging to observe the evolution of dissections.Results The MR feature of extracranial dissection was crescentic shape intramural hematoma,while the intracranial dis-section was aneurysmal dilatation.The CTA feature of extracranial dissection was intimal flap or a double lumen, while the intracranial dissection was aneurysmal dilatation with thrombus and calcification.The DSA feature of ex-tracranial dissection was artery stenosis,intimal flap or a double lumen,while the intracranial dissection was “pearl and string sign”.3 cases of SAH patients were diagnosed as vertebral artery dissections by the dynamic imaging.5 patients with extracranial dissections were given dynamic imaging to observe the evolution.4 of them were healed spontaneously,the other one was performed stent placement because of the dissection progressed.Conclusion Mul-timode dynamic imaging can improve the diagnosis rate of vertebral artery dissection,and can help to obtain more detailed diagnostic information and observe the evolution of vertebral artery dissections.It has an important guiding significance in making clinical treatment strategies.