后循环短暂性脑缺血发作的椎基底动脉影像学分析
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摘要
目的探讨后循环短暂性脑缺血发作(TIA)的椎基底动脉影像学特征。方法选取本院2007年3月至2016年3月符合入组条件的后循环TIA患者139例。入组患者完善头颈部CTA、头颈部增强MRA(CE-MRA)或全脑DSA等影像学检查。结果 95例患者行头颈部CTA检查椎基底动脉中有10例正常,8例轻度狭窄,61例中度狭窄,9例疑似重度狭窄,7例其他情况。44例患者行头颈部CE-MRA检查椎基底动脉中有3例正常,4例轻度狭窄,15例中度狭窄,19例疑似重度狭窄,3例其他情况。对疑似重度狭窄的28例(CTA 9例,CE-MRA 19例)患者均行全脑DSA检查,其中9例CTA患者有8例存在重度狭窄,1例中度狭窄;19例CE-MRA患者有15例存在重度狭窄,2例中度狭窄,2例其他情况。最终139例后循环TIA患者中椎基底动脉正常13例(9.4%)、轻度狭窄12例(8.6%)、中度狭窄79例(56.8%)、重度狭窄23例(16.6%)、其他12例(8.6%)。结论椎基底动脉中重度狭窄是后循环TIA重要的影像学表现,两者关系密切。
Objective To investigate the imaging features of vertebral basilar artery in patients with posterior circulation transient ischemic attack(TIA). Methods A total of 139 patients with posterior circulation TIA who met the inclusion criteria were recruited in our hospital from March 2007 to March 2016. All the recruited patients received imaging examination, such as head and neck computed tomography angiography(CTA), head and neck contrast-enhanced magnetic resonance angiography(CE-MRA) or whole brain digital subtraction angiography(DSA). Results Among 95 patients who underwent head and neck CTA, there were normal in 10 cases, mild stenosis in 8 cases, moderate stenosis in 61 cases, suspected severe stenosis in 9 cases, and other situations in 7 cases. A total of 44 patients received head and neck CE-MRA, which showed normal in 3 cases, mild stenosis in 4 cases, moderate stenosis in 15 cases, suspected severe stenosis in 19 cases, and other situations in 3 cases. The 28 patients with suspected severe stenosis(9 cases of CTA,19 cases of CE-MRA) underwent whole brain DSA, which showed that 8 of 9 cases had probable severe stenosis, with 1case had moderate stenosis, and 15 of 19 cases had suspected severe stenosis, with moderate stenosis in 2 cases and other situations in 2 cases. Among 139 patients with posterior circulation TIA, there were normal in 13 cases(9.4%), mild stenosis in 12 cases(8.6%), moderate stenosis in 79 cases(56.8%), severe stenosis in 23 cases(16.6%), and other situations in 12 cases(8.6%). Conclusion Moderate or severe stenosis of vertebral basilar artery stenosis is an important imaging manifestation of posterior circulation TIA, which indicated close relationship between the two.
Objective To investigate the imaging features of vertebral basilar artery in patients with posterior circulation transient ischemic attack(TIA). Methods A total of 139 patients with posterior circulation TIA who met the inclusion criteria were recruited in our hospital from March 2007 to March 2016. All the recruited patients received imaging examination, such as head and neck computed tomography angiography(CTA), head and neck contrast-enhanced magnetic resonance angiography(CE-MRA) or whole brain digital subtraction angiography(DSA). Results Among 95 patients who underwent head and neck CTA, there were normal in 10 cases, mild stenosis in 8 cases, moderate stenosis in 61 cases, suspected severe stenosis in 9 cases, and other situations in 7 cases. A total of 44 patients received head and neck CE-MRA, which showed normal in 3 cases, mild stenosis in 4 cases, moderate stenosis in 15 cases, suspected severe stenosis in 19 cases, and other situations in 3 cases. The 28 patients with suspected severe stenosis(9 cases of CTA,19 cases of CE-MRA) underwent whole brain DSA, which showed that 8 of 9 cases had probable severe stenosis, with 1case had moderate stenosis, and 15 of 19 cases had suspected severe stenosis, with moderate stenosis in 2 cases and other situations in 2 cases. Among 139 patients with posterior circulation TIA, there were normal in 13 cases(9.4%), mild stenosis in 12 cases(8.6%), moderate stenosis in 79 cases(56.8%), severe stenosis in 23 cases(16.6%), and other situations in 12 cases(8.6%). Conclusion Moderate or severe stenosis of vertebral basilar artery stenosis is an important imaging manifestation of posterior circulation TIA, which indicated close relationship between the two.
引文
[1]翁秋燕,胡兴越.后循环缺血的临床及影像学特点探讨[J/CD].中华临床医师杂志(电子版),2010,4(9):I0032-I0034.
[2]中国后循环缺血专家共识组.中国后循环缺血的专家共识[S].中华内科杂志,2006,45(9):786-787.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑血管病一级预防指南2015[S].中华神经科杂志,2015,48(8):629-643.
[4]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[S].中华神经科杂志,1996,29(6):379-380.
[5]Committee NASCETNS.North American Symptomatic Carotid Endarterectomy Trial.Methods,patient characteristics,and progress[J].Stroke,1991,22(6):711-720.
[6]邓方,饶明俐,李霞,等.428例短暂性脑缺血发作患者的临床资料分析[J].中风与神经疾病杂志,2009,26(5):538-540.
[7]曹利民,李红琴,王洪生,等.椎动脉优势对老年后循环短暂性脑缺血发作患者近期预后的分析[J].中华老年心脑血管病杂志,2015,17(4):372-374.
[8]Heyman A,Wilkinson WE,Hurwitz BJ,et al.Risk of ischemic heart disease in patients with tia[J].Neurology,1984,34(5):626-630.
[9]Sylaja PN,Hill MD.Transient ischemic attacks-definition,risk prediction and urgent management[J].Neurol India,2009,57(3):252-256.
[10]刘锋昌.脑血管造影对后循环短暂性脑缺血发作患者预后的评估价值[J].海南医学,2012,23(18):65-66.
[11]陆建平,刘崎,何新红,等.三维对比增强MR血管成像对颈部动脉病变的诊断价值[J].中华放射学杂志,2004,38(1):76-81.
[2]中国后循环缺血专家共识组.中国后循环缺血的专家共识[S].中华内科杂志,2006,45(9):786-787.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑血管病一级预防指南2015[S].中华神经科杂志,2015,48(8):629-643.
[4]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[S].中华神经科杂志,1996,29(6):379-380.
[5]Committee NASCETNS.North American Symptomatic Carotid Endarterectomy Trial.Methods,patient characteristics,and progress[J].Stroke,1991,22(6):711-720.
[6]邓方,饶明俐,李霞,等.428例短暂性脑缺血发作患者的临床资料分析[J].中风与神经疾病杂志,2009,26(5):538-540.
[7]曹利民,李红琴,王洪生,等.椎动脉优势对老年后循环短暂性脑缺血发作患者近期预后的分析[J].中华老年心脑血管病杂志,2015,17(4):372-374.
[8]Heyman A,Wilkinson WE,Hurwitz BJ,et al.Risk of ischemic heart disease in patients with tia[J].Neurology,1984,34(5):626-630.
[9]Sylaja PN,Hill MD.Transient ischemic attacks-definition,risk prediction and urgent management[J].Neurol India,2009,57(3):252-256.
[10]刘锋昌.脑血管造影对后循环短暂性脑缺血发作患者预后的评估价值[J].海南医学,2012,23(18):65-66.
[11]陆建平,刘崎,何新红,等.三维对比增强MR血管成像对颈部动脉病变的诊断价值[J].中华放射学杂志,2004,38(1):76-81.