【摘要】 目的：对椎动脉V3段异常进行3D解剖分型，为临床诊疗提供参考。方法：搜集整理2017年1月至2021年12月收治的257例枕颈交界区病变且行椎动脉计算机体层血管成像（CTA）的患者的影像资料。借助医院影像信息系统的三维成像功能将椎动脉V3段与骨骼数据进行复合渲染后得到椎动脉V3段-骨骼3D模型，再对异常椎动脉进行分型。结果：本研究共收集了514条椎动脉数据。其中异常椎动脉308条（59.92%,308/514）。根据异常椎动脉发生原因，将308条异常椎动脉分为两型。Ⅰ型为骨质异常导致，占异常椎动脉的27.60%；Ⅱ型为走行异常导致，占异常椎动脉的72.40%。Ⅰ型根据椎动脉被骨质覆盖的程度分为Ⅰa半钩环型、Ⅰb钩环型、Ⅰc全骨质内型。Ⅱ型根据椎动脉在寰椎后弓上下走行的不同分为Ⅱa椎动脉迂曲型、Ⅱb椎动脉位于寰枢椎节段间型、Ⅱc椎动脉在寰椎后弓附近分叉型。结论：基于CTA 3D重建模型建立的椎动脉V3段分型可以为临床提供重要解剖和外科应用参考。更多还原

【Abstract】 Objective: To perform three-dimentional(3D) anatomical classification of abnormalities in the third vertebral artery segment so as to provide references for clinical diagnosis and treatment. Methods: Imaging data were collected from 257 patients who were admitted to our hospital for occipitocervical junction lesions from Januaray 2017 to December 2021 and examined by computed tomographic angiography(CTA) for vertebral artery. The 3D imaging function of picture archiving and communication system(PACS)in our hospital was used to make composite rendering for the V3 vertebral artery and bone data to obtain the 3D model of V3 vertebral artery and bone. Results: A total of 308 abnormal vertebral arteries were classified out of 514 vertebral arteries(59.92%, 308/514).According to the causes of abnormal vertebral arteries, the 308 vertebral arteries were divided into type Ⅰ(caused by abnormal bone,27.60%, 85/308) and type Ⅱ(caused by abnormal pathway, 72.40%, 223/308). According to the degree of vertebral artery covered by osseous tissue, type Ⅰ was subdivided into type Ⅰa of partial-arcuate foramen, type Ⅰb of arcuate foramen, and type Ⅰc of complete osseous coverage. According to the different pathways of vertebral artery above and below the posterior arch of atlas, type Ⅱ was subdivided into type Ⅱa of the tortuous vertebral artery, type Ⅱb of the intersegmental vertebral artery located between C1 and C2, and type Ⅱc of the bifurcated vertebral artery near the posterior arch of atlas. Conclusions: The classification of V3 vertebral artery based on CTA 3D reconstruction model can provide important reference for clinical anatomic and surgical application.更多还原