【摘要】 目的 应用MRI及MRA对后循环缺血(posterior circulation ischemia,PCI)患者椎-基底动脉的走行异常进行评价,探讨其与后循环缺血的关系。方法 对960例后循环缺血患者的MRI和MRA显示的椎-基底动脉血管形态、位置进行观察,分析基底动脉迂曲与优势椎动脉的关系,椎-基底动脉迂曲及优势椎动脉与大脑后循环梗死的关系。结果 左侧椎动脉优势388例占40.4%(388/960),右侧椎动脉优势213例占22.2%(213/960),基底动脉向右迂曲376例,向左迂曲203例,两侧椎动脉等粗的359例中,基底动脉迂曲22例,优势椎动脉与基底动脉迂曲之间有统计学意义(χ~2=781.26,P=0.00),且基底动脉迂曲方向与优势椎动脉呈相反方向;基底动脉迂曲和椎动脉优势与大脑后循环特定部位的梗死有密切的关系,梗死主要发生于椎基动脉连接前非优势椎动脉侧和连接后基底动脉弯曲对侧。结论 椎动脉颅内段优势动脉存在与基底动脉迂曲具有相关性,且基底动脉迂曲方向与优势椎动脉呈相反方向;椎-基底动脉迂曲、移位可引起后循环缺血。了解椎-基底动脉迂曲、移位演变过程,为临床探索PCI发病机制、完善防治措施提供依据。更多还原

【Abstract】 Objective To investigate the relationship between morphological changes of vertebrobasilar arteries with MRI and MRA and posterior circulation ischemia.Methods Morphology and position of vertebrobasilar arteries in 960 patients with posterior circulation ischemia were observed.Relationships between tortuosity of basilar artery and preponderance of vertebral artery,and between vertebrobasilar tortuosity,vertebral artery preponderance and posterior cerebral circulation infarction were analyzed.Results Preponderant vessels of left or right vertebral artery were in 40.4%(388/960) or 22.2%(213/960).The number of the tortuous basilar arteries to right or left side were 376 or 203,respectively.There were 22 cases with tortuous basilar artery in 359 cases with the same diameter of vertebral arteries in bilateral sides.A significant difference was found between tortuosity of basilar artery and preponderance of vertebral artery(χ~2=781.26,P=0.00).Tortuosity of the basilar artery and preponderance of the vertebral artery were closely related to the specific position of posterior cerebral circulation infarction which occurred mainly in the side of nonpreponderant vertebrobasilar artery and in the opposite side of tortuous basilar arteries.Conclusion There is a close correlation between tortuosity of basilar artery and preponderance of vertebral artery.Tortuous basilar artery usually occurs in the opposite side of the preponderant vertebral artery.Tortuosity and displacements of vertebrobasilar artery may result in the posterior circulation ischemia.更多还原