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目的进一步评价血管结构变化在后循环缺血中的重要性。方法对126例临床诊断为后循环缺血的患者行CT血管造影(CTA)和数字减影血管造影(DSA)检查资料进行回顾性分析。结果 126例后循环缺血患者中,后循环合并前循环病变34例,单纯前循环病变12例;基底动脉狭窄2例,单侧椎动脉血管狭窄26例,单侧椎动脉发育不良61例;大脑后动脉狭窄39例,发育不良26例;小脑下后动脉狭窄21例,发育不良6例;三叉永存动脉1例;(单纯锁骨下动脉狭窄)椎动脉盗血1例;全部病例检出正常的18例,其中MRI检查已发现有小脑梗塞,CTA及DSA检查正常2例。结论后循环血管结构变化是后循环缺血的根本因素,CTA及DSA检查,对于评价颅内近端或是远端血管病变,决定治疗方案具有重要临床指导意义。
Objective To further evaluate the importance of vascular structural changes in posterior circulation ischemia. Methods 126 patients with clinically diagnosed posterior circulation ischemia underwent CT angiography (CTA) and digital subtraction angiography (DSA) examination data were retrospectively analyzed. Results Among the 126 patients with posterior circulation ischemia, 34 cases had posterior circulation complicated with anterior circulation lesions, 12 cases had anterior circulation lesions only, 2 cases with basilar artery stenosis, 26 cases with unilateral vertebral artery stenosis and 61 cases with unilateral vertebral artery dysplasia. 39 cases of posterior cerebral artery stenosis, 26 cases of dysplasia; 21 cases of inferior cerebellar artery stenosis, 6 cases of dysplasia; 1 case of trigeminal permanent artery; 1 case of vertebral artery steal (simple subclavian artery stenosis); all cases were detected as normal Of 18 cases, of which MRI examination has found that there are 2 cases of cerebellar infarction, CTA and DSA examination was normal. Conclusions The changes of posterior circulation vascular structure are the fundamental factors of posterior circulation ischemia. CTA and DSA examination have important clinical significance in evaluating intracranial proximal or distal vascular lesions and determining treatment regimen.