螺旋CT血管造影对椎基动脉供血不足的诊断价值

目的：探讨螺旋CT血管造影（CTA）对椎基动脉供血不足的诊断与鉴别诊断价值。方法：80例经颅多普勒超声提示有椎基动脉供血不足的患者行CTA检查。其中20例在CTA检查1周内接受减数血管造影（DSA）检查。结果：（1）CTA对椎动脉狭窄程度的评价与DSA呈高度相关（r=0.837P,0.001)，对发育不良，血管扭曲的判断与DSA完全一致，对椎动脉起始端钙化的开口位置的显示优于DSA。（2）80例160条椎动脉中，正常88条（55.0%)。粥样硬化性狭窄29条（18.1%)。发育不良性狭窄20条（12.5%)。非自然扭曲18条（11.3%)。扭曲伴狭窄5条（3.1%)。另见起始端钙化7条。结论：CTA能清晰地显示全程椎基动脉系统，对椎基动脉供血不足的病因诊断，预后估计及治疗方案的选择都有重要的临床意义。

Diagnostic Value of Spiral CT Angiography in Vertebrobasilar Insufficiency

Objective: To investigate the diagnostic and differential diagnostic value of spiral computed tomography angiography(CTA) in vertebrobasilar insufficiency. Methods: We performed CTA on 80 patients with vertigo diseases in which transcranial Doppler(TCD) proved vertebrobasilar insufficiency. CTA data were displayed on multiplanar reformation(MPR) and maximum intensity projection(MIP) images. 20 cases underwent intra-arterial digital subtraction angiography(DSA) within a week of CTA examination. Results: (1) A strong correlation was found between the degrees of vertebral artery stenosis estimated by DSA and CTA image( r=0.837 P <0.001). Also, 7 cases of anatomic variant were diagnosed accurately by CTA. CTA was more sensitive for determining calcification and ostium of the vertebral artery than DSA. (2) There were a total of 160 vertebral artery studied. CTA revealed 15 mild, 10 moderate, and 4 severe stenoses and 20 hypoplasia stenoses. On the other hand, 5 stenoses with kinkings,18 kinkings and 7 calcified plaques were detected. Conclusion: CTA enable accurate evaluation of vertebrobasilar artery. It has an important clinical significance for etiologic study, prognosis judgement and guiding therapy of vertebrobasilar insufficiency.