双侧胚胎型大脑后动脉患者基底动脉发育不良在后循环缺血发生中的作用

目的 探讨双侧胚胎型大脑后动脉患者基底动脉发育情况及其血流流速在后循环缺血发生中的作用。方法 前瞻性选取2014年3月—2015年5月包头医学院第三附属医院神经内科经1.5 T或3.0 T MRA证实为双侧胚胎型大脑后动脉的住院患者40例为观察组,以头晕等症状门诊就诊、头颅MRA显示无胚胎型大脑后动脉且基底动脉发育正常的52例患者为对照组。对所有实验对象的基底动脉直径在MRA原始图像上使用MR扫描仪自带VolumeView软件远、中、近三段中点截面进行测量;使用经颅多普勒(TCD)检测基底动脉血流流速,并对患者后循环缺血的发生情况进行统计分析。结果 观察组和对照组患者基底动脉直径分别为(1.98±0.20)mm、(3.40±0.47)mm,基底动脉血流流速分别为(36.0±5.6)cm/s 、(56.0±7.0)cm/s ,差异均有统计学意义(t=-19.602、-14.788, P值均<0.01);观察组患者后循环缺血的发生率20.0%(8/40),高于对照组的1.9%(1/52),差异有统计学意义(χ²=6.448, P<0.05)。结论 双侧胚胎型大脑后动脉患者基底动脉发育不良导致基底动脉血流流速减慢,致使后循环缺血的发生率升高,为后循环缺血的危险因素。

The role of basilar artery hypoplasia in the posterior circulation ischemia in patients with bilateral embryonal posterior cerebral artery

Objective To investigate the contralateral embryonal development of basilar artery in patients with posterior cerebral artery, and clinical relevance of posterior circulation ischemia and basilar artery blood flow. Methods From March 2014 to May 2015, the patients in Neurology Department of the Third Affiliated Hospital of Baotou Medical College by 1.5 T or 3.0 T and magnetic resonance angiography (MRA) confirmed for bilateral embryonal 40 patients with posterior cerebral artery were selected as the experimental group, 52 outpatients with dizziness head MRA showed no embryonal development of posterior cerebral artery and basilar artery normal were selected as control group. Basal artery diameter of all subjects in MRA original image was measured by using VolumeView software. Basilar artery blood flow velocity was detected by using Transcranial doppler ultrasonography (TCD) detection, and statistical analysis was carried out on the occurrence of posterior circulation ischemia. Results There was no difference between the two groups of patients with age and sexuality (all P values> 0.05), basal artery diameter was (1.98±0.20)mm and (3.40±0.47)mm, respectively(t=-19.602, P<0.01), basilar artery blood flow velocity was (36.0±5.6)cm/s and (56.0±7.0)cm/s, respectively(t=-14.788, P<0.01). The incidence rate of posterior circulation ischemia in experimental group(20.0%, 8/40) was higher than that in control group (1.9%, 1/52). There were significantly statistical differences between two groups(χ²=6.448, P<0.05). Conclusions Posterior circulation ischemia rate increases significantly in patients with bilateral embryonal posterior cerebral artery basilar artery hypoplasia. It is a risk factor for posterior circulation ischemia.