“开关征”-椎动脉压迫致颈内静脉狭窄二例DSA分析

目的探讨椎动脉压迫致同侧颈内静脉狭窄的DSA重要征象-开关征。方法分析2例颈内静脉狭窄患者的DSA影像学表现,并对照1例颈内静脉狭窄和1例颈内静脉闭塞患者的DSA表现。按照椎动脉弯曲的不同走行方式对椎动脉进行分型。结果本文2例患者椎动脉走出枢椎的横突孔后,1例水平向外、1例向前外走行,再穿过寰椎横突孔,从而形成了对颈内静脉的压迫。颈内静脉随着后方椎动脉的搏动,呈现压迫由轻到重,由重到轻连续变化的现象。压迫加重时,颈内静脉由狭窄至不全闭塞至致闭塞,造影剂由通过受限直至不能通过;压迫逐渐减轻时,颈内静脉由闭塞至不全开放至致开放,造影剂由不能通过至可以通过直至顺利通过,始终处于开-关-开-关的动态变化中。对于这种颈内静脉狭窄段随着其后方椎动脉的搏动,狭窄程度发生规律性变化的现象,作者命名其为"开关征"。结论 "开关征"是提示存在椎动脉压迫导致颈内静脉狭窄或闭塞的重要征象。

"Open and close sign"-Analysis of two cases jugular vein stenosis caused by Vertebral artery compression

Objective To study the DSA important signs of the internal jugular vein stenosis caused by the ipsilateral vertebral artery compression-open and close sign.Methods Analysising of 2 cases of internal jugular vein stenosis DSA imaging,and compared 1 case of jugular vein stenosis with 1 case of the internal jugular vein occlusion in patients with DSA results.Distinguished vertebral artery type by different bending of vertebral artery.Results The vertebral arteries in 2 patients were out of the transverse foram...