血管压迫延髓腹外侧与原发性高血压相关性研究

目的:评价原发性高血压与延髓腹外侧血管压迫的相关性。方法:2位有经验的影像诊断医师共同分析20例原发性高血压病人、10例继发性高血压病人、18例正常对照组的MRI。结果: 第一组中15例(n=20,75%)、第二组中1例(n=10,10%)、第三组中2例(n=18,11%)延髓头侧腹外侧部(RVLM)受压(P<0.01)。所见责任血管15例原发性高血压小脑后下动脉(PICA)10例(67%),小脑前下动脉(AICA)2例(13%),椎动脉(VA)3例(20%)。另3例为PICA。15例原发性高血压中分别见7例左、右单侧受压,1例两侧同时受压;另3例均为右侧受压。第一组中橄榄后沟中心与最近动脉的距离平均为(1.1±3.0)mm,第二组为(4.9±4.0)mm,第三组为(3.8±2.2)mm(P<0.05)。延髓髓质表面与最近动脉的距离,第一组为(0.5±0.9)mm,第二组为(1.5±1.6)mm,第三组为(1.6±2.1)mm,三组间无显著性差异。结论:原发性高血压与血管压迫RVLM关系密切,而与延髓其它部位受压无关。

Study on neurovascular compression of the rostral ventrolateral medulla related to essential hypertension

Objective: To prospectively evaluate neurovascular compression of the rostral ventrolateral medulla related to essential hypertension. Methods: Patients with essential hypertension(group 1; n=20), secondary hypertension(group 2; n=10), and normotensive subjects(group 3; n=18) underwent brain stem MR imaging and MR angiography. The images were interpreted consensually by two radiologists who were blinded to the patients' hypertensive status. Results: Neurovascular compression of the RVLM was observed in 15 of 20(75%) patients with essential hypertension; only 1 of the 10(10%) patients with secondary hypertension and only 2 of the 18(11%) normotensive subjects. The rate of neurovascular compression in the essential hypertension group was significantly higher than those in the other groups(P<0.01 for both). The distances between the RVLM and the nearest arteries in the essential hypertension group were significantly shorter than those in the other groups(P<0.05 for all). The distances between the surface of the medulla oblongata and the nearest arteries did not differ among these three groups. Conclusion: Neurovascular compression of the RVLM, but not of the other regions of the medulla oblongata, is particularly related to essential hypertension.