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目的总结脑动脉夹层的临床特点,影像学特征。方法回顾性分析我科近5年来经脑血管造影确诊的45例脑动脉夹层的特点,分析位置分布、临床表现、夹层形态的特征。结果脑血管造影共发现48处脑动脉夹层,其中双侧颈动脉夹层1例,双侧椎动脉夹层2例。夹层主要位于颅内段,占87.5%。前循环13例患者中,69.2%为非扩张性病变;后循环32例患者中,71.9%为扩张性病变。76.9%的前循环夹层表现为脑梗死,而65.6%的后循环夹层表现为蛛网膜下腔出血。根据夹层形态分析,81.5%的扩张性改变表现为蛛网膜下腔出血,而77.8%的非扩张性改变表现为脑梗死。结论脑动脉夹层多位于颅内段,后循环的夹层多为扩张性改变,多表现为蛛网膜下腔出血;前循环的夹层多为非扩张性改变,更多表现为脑梗死,血管造影有助于诊断。
Objective To summarize the clinical features and imaging features of cerebral arterial dissection. Methods The characteristics of 45 cases of cerebral artery dissection diagnosed by cerebral angiography in our department in recent 5 years were retrospectively analyzed. The location distribution, clinical manifestations and characteristics of dissection were analyzed. Results There were 48 cerebral artery dissections in cerebral angiography, including 1 case of bilateral carotid artery dissection and 2 cases of bilateral vertebral artery dissection. Mezzanine is mainly located in the intracranial segment, accounting for 87.5%. Of the 13 patients who had anterior circulation, 69.2% were non-dilative and 71.9% of the 32 patients with posterior circulation were dilated. 76.9% of the anterior circulation dissection showed cerebral infarction, while 65.6% of the posterior circulation dissection showed subarachnoid hemorrhage. According to the mezzanine morphology analysis, 81.5% of the expansive changes showed subarachnoid hemorrhage, while 77.8% of the non-expansive changes showed cerebral infarction. Conclusions Most of the cerebral arteries are located in the intracranial segment. The posterior circulation dissection mostly changes in dilatation, and most of them show subarachnoid hemorrhage. The anterior circulation dissection mostly changes non-dilatation, and more manifestations are cerebral infarction, angiography To help diagnose.