椎-基底动脉形态与发生脑干梗死的关系:623例临床分析

摘要

目的 研究基底动脉弯曲与双侧椎动脉粗细差异的关系,基底动脉弯曲及双侧椎动脉粗细不等与发生脑干梗死的关系.方法 按时间顺序提取2005年7月至2006年7月进行头颅磁共振成像(MRI)和磁共振脑动脉造影(MRA)检查的623人的影像资料,观察基底动脉弯曲4个等级中双侧椎动脉粗细不等发生率、基底动脉弯曲方向与椎动脉细侧侧别一致率、基底动脉弯曲4个等级中脑干梗死发生情况及双侧椎动脉粗细不等样本中梗死发生情况.结果 在基底动脉0至3度弯曲样本中,双侧椎动脉粗细不等的发生率分别为54%,85%,83%和80%,基底动脉0度组与1,2度组有显著差异.在基底动脉1至3度弯曲且双侧椎动脉粗细不等的样本中,椎动脉细侧所在侧别与基底动脉弯曲方向的一致率为83%.基底动脉无弯曲(0度弯曲)和基底动脉1至3度弯曲组间脑干梗死发生率无明显差异.双侧椎动脉粗细相等与不等组脑干梗死发生率无明显差异.结论 在本组资料中,双侧椎动脉粗细不等可能是基底动脉弯曲的原因之一,基底动脉的弯曲程度及双侧椎动脉粗细不等对脑干梗死的发生未构成影响.%Objective To study the relationship of the vertebrobasilar dolichoectasia (VBD) with the difference in two vertebral arteries diameter and their relationship with brain stem infarction incidences. Methods The data of 623 individuals who received both cranial magnetic resonance imaging and magnetic resonance angiography from July 2005 to July 2006 in our hospital were collected sequentially. The incidence of the different diameter of the two vertebral arteries in individuals with different scales of VBD, the agreement rate of the direction of the VBD and site of the thinner side of the vertebral artery, and the brain stem infarction incidences in individuals with different scales of VBD and individuals with different diameter of the two vertebral arteries, were analyzed. Results In samples of VBD with scale 0 to 3, the incidences of different diameter of the two vertebral arteries were 54％, 85％, 83％ and 80％, respectively. There was significant difference between the scale 0 samples and scale 1 and 2 samples. In individuals with scale 1 to 3 VBD and also with different diameter of the two vertebral arteries, the agreement rate of the direction of the VBD and the thinner side of the vertebral artery was 83％. There was no difference in brain stem infarction incidences between scale 0 and scale 1 to 3 VBD individuals, and between individuals with similar and different diameter of the two vertebral arteries. Conclusion The difference of the diameter of the two vertebral arteries may be one of the causes of the VBD. The degree of the VBD and the difference of the diameter of the two vertebral arteries have no effect on the brain stem infarction incidences.