梭形细胞/硬化性横纹肌肉瘤20例临床病理学观察

目的:探讨梭形细胞/硬化性横纹肌肉瘤(spindle cell/sclerosing rhabdomyosarcoma,SRMS)的临床病理学特征、免疫表型,及MyoD1表达与基因突变的关系。方法:收集2009至2019年20例空军军医大学(第四军医大学)西京医院SRMS病例资料和切片。对肿瘤切除标本进行组织学形态和免疫组织化学EnVision染色,对12例进行MYOD1基因Sanger法测序分析。结果:20例包括儿童12例和成人8例,其中男性11例,女性9例,年龄8个月至85岁,平均22岁。患者临床主要表现为逐渐增大的无痛性肿块。发生于头颈部7例,腹盆腔7例(腹腔4例、盆腔2例、左侧胸腹腔1例),上肢5例(左肩部2例、右腋下1例、右肱骨1例、左前臂1例),背部1例。肿瘤直径2.5~20.0 cm,平均6.2 cm。病理组织学观察,肿瘤主要由梭形细胞组成,呈束状排列,其中7例至少部分区域呈鱼骨样或人字形的束状排列,似成人型纤维肉瘤;4例可见不同程度明显的间质硬化,2例局部可见血管外皮细胞瘤样结构,4例出现疏松黏液样区域,9例可见不同程度的坏死灶。有3例在梭形细胞之间有少量的梭形或多角形的横纹肌母细胞。在该组病例中,16例为纯梭形细胞,2例为纯硬化性,2例为梭形细胞/硬化性混合性横纹肌肉瘤。免疫组织化学显示,梭形细胞均为结蛋白阳性,以及Myogenin和/或MyoD1不同程度阳性;而其他标志物,如广谱细胞角蛋白、间变性淋巴瘤激酶1、CD34、上皮细胞膜抗原、HMB45、H-cald、平滑肌肌动蛋白和S-100蛋白均阴性。12例测序病例中,有4例(4/12)检测到MYOD1基因p.L122R位点突变。有效随访12例,时间1~51个月,3例因多发转移死亡,3例复发,2例带瘤生存。结论:SRMS是少见类型的横纹肌肉瘤,好发于头颈部,多见于儿童,成人较少见。有MYOD1基因突变的SRMS通常有弥漫的MyoD1核阳性,与更具有侵袭性的生物学行为有关。     

硬化性横纹肌肉瘤的临床病理学分析

目的探讨硬化性横纹肌肉瘤（SRMS）的临床病理学特征,以及与胚胎性横纹肌肉瘤（ERMS）和腺泡状横纹肌肉瘤（ARMS）之间的关系。方法观察4例SRMS的临床特点、光镜形态,以免疫组织化学染色[En Vision法;波形蛋白、结蛋白、α-平滑肌肌动蛋白（α-SMA）、肌特异性肌动蛋白（MSA）、生肌蛋白、肌调节蛋白（MyoD1）、高分子量钙调结合蛋白（h-CALD）、CD31、CD34、第Ⅷ因子相关抗原、S-100蛋白、细胞角蛋白（AE1／AE3）和问变性大细胞淋巴瘤激酶（ALK1）]确定免疫学表型。结果4例均发生于成年人,平均年龄41．5岁。男性2例,女性2例。肿瘤分别位于左腕部、右大腿、右颊部和右面部,直径大小为2．5—10．0cm,平均5．7cm。镜下以含有大量玻璃样变的基质为特征,类似原始的骨样组织或软骨样基质。瘤细胞主要由原始的小圆形细胞组成,其排列方式呈多样化,包括条束状、索状、列兵样、梁状、微腺泡状和假血管样排列等。除1例可见少量的横纹肌母细胞外,其余3例均未见横纹肌母细胞,也未见花环状多核巨细胞。2例的局部区域还含有梭形细胞成分,其中1例类似梭形细胞横纹肌肉瘤,另1例类似周围神经肿瘤。免疫组织化学标记显示,瘤细胞弥漫强阳性表达MyoD1,而结蛋白多为灶性表达,生肌蛋白多为阴性或仅为灶性阳性。3例表达MSA,2例表达Ot-SMA,但不表达h-CALD。S-100蛋白、CD31和ALK1等标记均为阴性。结论SRMS在形态上和免疫学表型上与ERMS和ARMS均有所不同,但在细胞遗传学上与ERMS关系密切。熟悉SRMS的形态特征和免疫学表型有助于识别这种少见的横纹肌肉瘤亚型及与其他硬化性肿瘤相鉴别。     

儿童梭形细胞横纹肌肉瘤10例临床病理分析

目的探讨儿童梭形细胞横纹肌肉瘤的临床病理特征、诊断及鉴别诊断。方法回顾性分析10例儿童梭形细胞横纹肌肉瘤的临床病理学特征并复习相关文献。结果镜下主要表现为长梭形的肿瘤细胞,部分区域可见典型的胚胎性横纹肌肉瘤区或分化较好的横纹肌母细胞区,肿瘤细胞表达肌源性标记desmin、Myogenin和MyoD1,Ki-67核增殖指数为15%~60%。结论儿童梭形细胞横纹肌肉瘤少见,易漏诊或误诊,需与儿童常见的其他梭形细胞肿瘤相鉴别。     

钙化性纤维性肿瘤的临床病理学分析

目的探讨钙化性纤维性肿瘤(calcifying fibrous tumor,CVF)的临床病理学特征、免疫表型和鉴别诊断。方法回顾性分析7例CFT的临床资料、病理学形态和免疫组化标记结果。结果患者中1例为少年,6例均为成年人,年龄14—50岁,平均37岁。5例临床表现为局部缓慢性生长的无痛性肿块,2例为术中偶然发现。肿瘤分别位于腹腔／盆腔(3例)、颈部(2例)、左腹股沟(1例)和左小腿(1例)。眼观：肿块境界清楚,卵圆形或结节状,质地坚韧。镜检：肿瘤由大量胶原化的纤维结缔组织组成,其间夹杂少量梭形细胞。特征性形态学表现为在胶原化的纤维组织间可见散在的钙化灶或砂砾小体,间质内伴有多少不等的淋巴细胞和浆细胞浸润灶,部分病例中可见生发中心形成。免疫组化标记显示,梭形细胞主要表达vimentin,不表达CD34、S-100蛋白、actin、desmin、h-caldesmon和ALK1等标记。随访6例,均无复发。结论CFT是一种不同于炎性肌纤维母细胞瘤的良性纤维母细胞性肿瘤。CFT不仅好发于儿童和青少年,也可发生于成年人。组织学上应与伴有钙化的纤维母细胞／肌纤维母细胞性病变相鉴别。     

炎症性横纹肌母细胞肿瘤3例临床病理学分析

目的探讨炎症性横纹肌母细胞肿瘤的临床病理学特征。方法回顾性分析2例富含组织细胞横纹肌母细胞肿瘤(HRRMT)及1例炎症性横纹肌母细胞肿瘤(IRMT)的组织形态学及免疫表型特点, 并复习相关文献。结果 3例肿块均境界清楚, 2例实性, 1例囊实性。镜下见纤维性假包膜, 肿瘤细胞梭形、上皮样、横纹肌母细胞样, 伴大量炎症细胞、组织细胞浸润。肿瘤细胞显示程度不等的多形性, 但核分裂象罕见, 未见肿瘤性坏死。免疫表型:肿瘤细胞强阳性表达结蛋白(3/3);程度不等地表达骨骼肌标志物(Myogenin或MyoD1), 其中1例约20%肿瘤细胞表达平滑肌肌动蛋白(SMA);均不表达间变性淋巴瘤激酶(ALK, D5F3);Ki-67阳性指数5%～10%。结论 IRMT是新近描述的中间型/交界性横纹肌肿瘤, 诊断依赖于形态学及免疫组织化学, 熟悉其临床病理特征有助于认识这一新类型的肿瘤。     

间叶性软骨肉瘤伴横纹肌标志物异常表达2例临床病理学分析

目的探讨间叶性软骨肉瘤(mesenchymal chondrosarcoma, MC)伴横纹肌标志物异常表达的临床病理学特征。方法收集福建省立医院2006年9月至2021年9月2例异常表达横纹肌标志物的MC患者的临床资料、影像学检查、病理特征, 荧光原位杂交(FISH)检测NCOA2基因及二代测序检测, 并复习相关文献。结果例1女, 34岁。例2男, 19岁。2例肿瘤发生部位分别为盆腔及前列腺。镜下观察:肿瘤由未分化的小细胞和透明软骨岛构成。小细胞呈圆形、卵圆形、短梭形, 排列为片状、巢状, 可见血管外皮瘤样结构, 2例灶性可见细胞质嗜酸性横纹肌母细胞。免疫表型:SOX9小细胞与软骨阳性, 软骨细胞S-100蛋白阳性。2例横纹肌母细胞均MyoD1、Myogenin、结蛋白阳性。FISH检测均未检测到NCOA2基因分离, 二代测序检测例1有HEY1-NCOA2融合基因。结论 MC伴异常表达横纹肌标志物罕见, 易误诊, 诊断时需综合临床影像、病理、免疫组织化学, 必要时需借助分子甚至基因检测以明确诊断。     

硬化性横纹肌肉瘤2例并文献复习

目的 探讨硬化性横纹肌肉瘤(sclerosing rhabdomyosarcoma,SRMS)的临床病理特点,提高其诊断与鉴别诊断水平.方法 对2例SRMS组织进行免疫组织化学染色并文献复习.结果 患者男女各1例,年龄分别为16、28岁,发生部位分别在左颌下及脊柱旁,临床表现均为无痛性肿块.大体均为灰白肿块,质地中等,边界不清.镜下2例组织学形态基本一致,肿瘤内均含有大量嗜伊红色玻璃样变的基质,类似原始软骨样或骨样基质,肿瘤细胞主要由原始小圆细胞组成,呈条索样、梁状、腺管状、微腺泡状和假血管样排列.免疫组织化学示瘤细胞vimentin(+)、MyoD1细胞核(+).结论 SRMS是一种罕见的肉瘤类型,兼具腺泡状横纹肌肉瘤(alveolar rhabdomyosarcoma,ARMS)和胚胎性横纹肌肉瘤胚胎性横纹肌肉瘤(embryonal rhabdomyosarcoma,ERMS)部分形态特点,但与二者又不同.熟悉SRMS病理学特征和免疫表型对诊断和鉴别诊断具有重要意义.     

梭形细胞横纹肌肉瘤3例临床病理学分析及文献复习

目的探讨梭形细胞横纹肌肉瘤(spindle cell rhabdomyosarcoma,SCRM)的临床病理学特征、诊断及鉴别诊断。方法回顾性分析3例SCRM的临床表现、组织学与免疫表型特征,并复习相关文献。结果 3例均为男性婴幼儿,年龄2天~4岁。肿瘤部位:睾丸旁2例,腰背部1例,肿瘤直径2~6 cm;眼观:肿瘤边界清,无包膜,切面灰白色,质地韧。镜检:肿瘤呈侵袭性生长,边界尚清。瘤细胞由束状排列的梭形细胞组成,胞质深嗜伊红色,纤维状,可呈席纹状或漩涡状排列,局部区域可见波浪状结构,似神经纤维。部分细胞内可见横纹结构,有些区域见散在的横纹肌母细胞。瘤细胞间质内有少量胶原纤维。细胞核多为长圆形,有些细胞核呈纤细波浪状,细胞核异型不明显,核分裂象偶见。免疫表型:vimentin、desmin、myogenin和Myo D1均阳性,CK、α-inhabin、AFP、CD34、S-100蛋白均阴性。结论 SCRM是横纹肌肉瘤中一种少见的新类型,常发生于婴幼儿。需与婴儿纤维瘤病、先天性纤维肉瘤、纤维肉瘤、平滑肌肉瘤、恶性蝾螈瘤及促纤维组织的恶性黑色素瘤相鉴别。     

浅表肢端纤维黏液瘤的临床病理特征

目的 探讨浅表肢端纤维黏液瘤(SAF)的临床病理学特点、免疫表型和鉴别诊断.方法 对1例发生于左手中指末端SAF的临床表现、组织形态和免疫学表型进行回顾性分析,并复习文献.结果 患者男,62岁.因左手中指背侧末端肿块伴疼痛就诊,曾有外伤史.术中见肿块近甲床,并深达骨膜.大体观察,肿块周界不清,直径约2 cm,切面呈灰白色,实性,质韧.镜下观察,肿瘤位于真皮层内,略呈分叶状.瘤细胞由梭形至星形纤维母细胞样细胞组成,呈杂乱状分布于黏液样基质内,局部区域可呈条束状或疏松的席纹状排列.黏液样基质内含有丰富的纤细血管,并可见较多散在的肥大细胞.瘤细胞异型性不明显或仅显示轻度的异型性,核分裂象罕见.肿瘤内也未见坏死.免疫组织化学标记显示,梭形和星形细胞表达波形蛋白、CD34和CD99,灶性表达CD10,不表达上皮细胞膜抗原、肌动蛋白、结蛋白和S-100蛋白.结论 SAF好发于成年人指趾末端.熟悉其临床病理特点则有助于与其他发生于指趾的软组织黏液性肿瘤相鉴别.临床上宜将SAF作完整性切除,以预防局部复发.     

化生性胸腺瘤2例临床病理分析

目的：探讨化生性胸腺瘤的临床及病理学特征。方法：应用光镜及免疫组织化学方法观察2例化生性胸腺瘤的组织学特点及免疫学表型,并复习相关文献。结果：2例均为男性,年龄55岁及56岁。组织学肿瘤显示双相分化特点,上皮细胞区域与梭形细胞区域交错分布并相互移行。上皮细胞呈相互吻合的束状、岛状及宽大的梁状排列,细胞轻度异型,可见核沟及核内假包涵体,偶见核分裂像;梭形细胞呈短束状或席纹状排列,细胞温和,未见核分裂像。免疫表型：上皮细胞区域CK19和AE1/AE3呈强阳性表达,上皮膜抗原（epithelial membrane antigen,EMA）弱阳性;梭形细胞区域表达Vimentin、Bcl-2及CD99,AE1/AE3局灶阳性,EMA弱阳性。两种区域中Ki67指数均〈5%。间质淋巴细胞CD3、CD5、CD20阳性,不表达Td T和CD99。结论：化生性胸腺瘤是一种罕见的良性或低度恶性胸腺肿瘤,诊断依靠病理组织学和免疫组织化学标记,完整切除预后良好。     

The differences of clinical manifestations and laboratory findings in children and adults with dengue virus infection.

BACKGROUND: Dengue haemorrhagic fever is an important public health problem and mainly occurs in children less than 15 years of age. Recently, the incidence of the disease have increased in adults but data on clinical and laboratory presentations of those affected are limited. OBJECTIVES: To assess and compare clinical manifestations and laboratory findings of dengue virus infected children and adults in Thailand. STUDY DESIGN: A 1-year study was conducted from September 2003 to August 2004 for dengue virus infected patients admitted to Phetchabun Provincial Hospital, Thailand. Physical signs, symptoms, and laboratory features were recorded. All dengue patients were confirmed using immunochromatographic test on convalescent sera. RESULTS: Based on serology-confirmed dengue virus infection, there was 286 dengue patients including 15 (5.3%) dengue fever and 271 (94.7%) dengue haemorrhagic fever (DHF). Among DHF cases, clinical classifications were DHF I, 40.9%; DHF II, 43%; and DHF III or dengue shock syndrome (DSS), 10.8%. Of all dengue patients, 231 cases (80.8%) were children aged less than 15 years and 55 cases (19.2%) were adults. The highest proportion of child cases was DHF I (42.9%), whereas that of adults was DHF II (51%). Some clinical manifestations were more common in adult patients, such as petechiae, melena, headache, retro-orbital pain, joint pain, myalgia, nausea and vomiting (p-value<0.05). Signs found commonly in children were epistaxis, oliguria, and liver enlargement (p-value<0.05). Haemoconcentration, thrombocytopenia, increased alanine aminotransferase, and longer prothrombin time were found to be significantly higher in adults than in children (p-value<0.05). CONCLUSIONS: Some clinical presentations of dengue disease and laboratory findings in adults are different from those in children. Therefore, adults as well as pediatric cases of DHF need appropriate and prompt case management to reduce the mortality rate of DHF.     

室管膜下巨细胞型星形细胞瘤的临床病理分析

目的探讨室管膜下巨细胞型星形细胞瘤的临床病理特征及预后。方法回顾性分析18例室管膜下巨细胞型星形细胞瘤的临床资料、光镜下特征和免疫组织化学染色(EnVision法)的特点。结果患者18例,平均年龄(18.2±12.4)岁(7~54岁),男∶女=2∶1;部位以侧脑室占绝大多数(16例,88.9%);11例(61.1%)伴有结节硬化症,以面部血管纤维瘤多见(8例,44.4%);症状以头痛、呕吐(11例,61.1%)最常见,其次为视力下降(3例,16.7%)。CT7例呈高密度,5例增强后强化;MRIT1WI等信号63.6%(7/11),T2WI高信号90.9%(10/11),增强后强化81.8%(9/11)。82.4%(14/17)获手术全切。随访4例,均存活,平均随访期3.5年(1~5年)。镜下见肿瘤细胞主要有核偏于一端、胞质丰富红染的梭形细胞,呈瓜子形的胖细胞以及节细胞样瘤细胞。免疫组织化学染色示梭形细胞以神经胶质标记如胶质纤维酸性蛋白(GFAP)为主(18/18,100%),而神经元标记如突触素主要在胖细胞、节细胞样瘤细胞表达(14/18,77.8%),16例(88.9%)MIB-1标记指数≤1%。结论室管膜下巨细胞型星形细胞瘤是具有独特组织病理学特点的良性肿瘤。好发于青少年。手术全切预后好。     

软组织多形性玻璃样变血管扩张性肿瘤的临床病理学观察

目的探讨软组织多形性玻璃样变血管扩张性肿瘤(pleomorphic hyalinizing angiectatic tumor of soft parts,PHAT)的临床病理特点。方法回顾性分析6例PHAT的临床资料、组织学形态和免疫组化标记,并复习相关文献。结果6例均发生于成年人,男性和女性各占3例,平均年龄为44岁。肿瘤分别位于下肢(3例)、颈部(2例)和腹膜后(1例)。临床上多表现为无痛性肿块,术前病程为3个月~38年。大体上,肿瘤境界清楚,结节状,平均直径为4.3 cm。切面呈灰白、灰红或灰褐色,部分病例可见出血性囊腔。镜下,肿瘤内含有成簇分布的薄壁扩张血管,血管壁附有一层厚的玻璃样变物质(纤维素和胶原纤维),可向血管周围间质内延伸,血管之间为片状分布的多形性瘤细胞,核大深染,核内可见假包涵体,但核分裂象罕见。部分区域内瘤细胞呈梭形,排列成条束状,类似神经鞘瘤。免疫组化标记显示,瘤细胞主要表达vimentin,部分病例还表达CD34和CD99,而S-100蛋白、α-SMA、bcl-2、EMA和CD68均为阴性。6例均经手术切除,随访8个月~13年,无1例复发。结论PHAT是一种具有低度恶性潜能的软组...     

Clinicopathologic findings in high-grade B-cell lymphomas with typical Burkitt morphologic features but lacking the MYC translocation

In the World Health Organization classification, cases with classical Burkitt morphologic features and a very high proliferation fraction but without the MYC translocation are not clearly designated as a separate entity and are usually categorized as diffuse large B-cell lymphoma (DLBCL). We identified from our records 33 cases of highly aggressive mature B-cell neoplasms from 8 children and 25 adults with typical Burkitt cytomorphologic, histologic, and immunophenotypic (CD20+/CD10+ and surface immunoglobulin-positive) features. Rearrangement of MYC (MYC+) was present in only 18 of 33 cases, but the proliferation fraction was more than 90% in all MYC-cases (no MYC rearrangement). The immunophenotype of the lymphoma cells in the 2 groups was similar. Although children with MYC+ and MYC- neoplasms were treated with chemotherapy regimens appropriate for Burkitt lymphoma, adults with MYC- lymphomas received less aggressive therapy usually given for DLBCL. Survival analysis showed that adults in the MYC- group had an inferior outcome compared with adults with MYC+ disease. Provisional identification of MYC- lymphomas with typical Burkitt morphologic features as an entity separate from DLBCL will facilitate further studies and possible categorization as a separate entity.     

Fibrous histiocytoma of the orbit. A clinicopathologic study of 150 cases

This is a clinicopathologic study of 150 cases of fibrous histiocytoma of the orbit. The tumors occurred in adults (median age, 43 years). The upper and nasal portions of the orbit were the most common sites of involvement. The most common signs and symptoms were proptosis (60 per cent), mass (46 per cent), and decreased vision (25 per cent). Based on the histopathologic features, the tumors were classified in three groups: benign (94 cases), locally aggressive (39 cases), and malignant (17 cases). The biological behavior correlated well with the duration of symptoms, the size and margins of the mass, and the histologic classification. The rate of recurrence was 31 per cent for the benign tumors, 57 per cent for the locally aggressive tumors, and 64 per cent for the malignant tumors. Follow-up data were obtained for 123 patients, with a mean duration of seven years. The ten-year survival of patients with benign, locally aggressive, and malignant fibrous histiocytoma was 100 per cent, 92 per cent, and 23 per cent, respectively. Nine patients died as a result of the tumor, six from local invasion of adjacent structures and three from metastatic disease. Fibrous histiocytoma is the most common primary mesenchymal orbital tumor of adults. The origin of the neoplasm is probably a primitive mesenchymal cell. Complete surgical excision appears to be the treatment of choice.     

Low grade fibromyxoid sarcoma: clinicopathological analysis of eleven new cases in support of a distinct entity

Low grade fibromyxoid sarcoma is a recently recognized, uncommon soft tissue neoplasm with a tendency to develop in deep soft tissue of young adults. Diagnostic criteria have not been well defined and this tumour has not been widely accepted as a distinct entity. Eleven new cases are reported here for which reproducible histological features are described and in which the immunohistochemical profile of the tumour cells is documented for the first time. Ten of the eleven patients were male and the majority were young or middle-aged adults (median age 45 years). All except one of the tumours were situated in deep soft tissue. Lower limb (four cases) and chest wall (three cases) were the commonest primary sites; one case each arose in the groin, buttock, axilla and retroperitoneum. Follow-up (median duration 6 years) was available in nine patients. Six developed local recurrence and in five cases recurrences were multiple. Pulmonary metastasis occurred in one patient. All tumours were characterized by the presence of bland spindle cells, showing a mainly whorled or focally linear arrangement, set in alternating areas with a fibrous or myxoid stroma. Tumour cells were small, spindle to stellate, with poorly defined, palely eosinophilic cytoplasm and hyperchromatic ovoid nuclei. Most tumour cells showed strong staining with antibodies to vimentin, while occasional cells stained positively for actin, desmin and cytokeratin, in keeping with focal myofibroblastic differentiation. Ultrastructural examination in one case revealed features of fibroblasts. Careful consideration of the morphological and immunohistochemical features of these tumours permits a positive diagnosis of low grade fibromyxoid sarcoma and allows its distinction from a number of other benign and malignant soft tissue neoplasms.     

健康体检成人基底动脉弯曲的磁共振血管成像影像解剖学特征

目的 探讨健康成人基底动脉弯曲的MR血管成像(MRA)表现及其解剖因素。方法 回顾性研究。2015年3月—2016年5月,北京丰台医院健康体检成人MRA检出基底动脉弯曲160例,其中男99例、女61例,年龄30~65岁。在基于MRA重建的最大密度投影(MIP)图像上观察基底动脉及椎动脉颅内段的形态、走行。应用SPSS 16.0软件,采用χ²检验比较健康人群基底动脉弯曲在椎动脉优势、椎动脉走行及汇合点变异间的分布差异性。结果 MRA检出基底动脉弯曲160例中,104例(65.0%)基底动脉右侧凸弯,56例(35.0%)基底动脉左侧凸弯,基底动脉右侧凸弯型占比多于左侧凸弯型。104例基底动脉右侧凸弯中84例(80.8%)为左优型椎动脉,56例基底动脉左侧凸弯中23例(41.1%)为右优型椎动脉,不同基底动脉弯曲类型间左优型与右优型椎动脉占比的差异有统计学意义(P＜0.017)。基底动脉右侧凸弯不伴左侧椎动脉优势型20例中,双侧椎动脉汇合前走行不对称者13例(65.0%)、对称者7例(35.0%),双侧椎动脉汇合点偏左侧8例(40.0%)、偏右2例(10.0%)、居中10例(50.0%);基底动脉左侧凸弯不伴右侧椎动脉优势型33例中,椎动脉汇合前走行不对称者23例(69.7%)、对称者10例(30.3%),双侧椎动脉汇合点偏左侧13例(39.4%)、偏右6例(18.2%)、居中14例(42.4%),两组间双侧椎动脉走行及汇合点位置差异均无统计学意义(P值均＞0.05)。结论 基底动脉弯曲的健康成人多伴发椎动脉优势变异;因其特殊的血流动力学特点,椎动脉优势可能是引发基底动脉弯曲的解剖学因素之一。