核磁共振在后循环缺血诊疗中的应用价值

目的探讨核磁共振(MR)在后循环缺血诊疗中的应用价值。方法选择58例后循环缺血住院病人,回顾性分析其基础疾病、临床表现及颈椎、颅脑核磁共振成像(MRI)、椎-基底动脉核磁共振血管造影(MRA)资料。结果颈椎MRI:69/(40/58)有不同程度的脊椎退变,颈椎曲度变直;31/(18/58)椎间盘膨出或突出,主要集中在脊椎5～脊椎8(C5～8)。椎-基底动脉MRA:82/(48/58)双侧椎动脉不对称,粗细不均;24/(14/58)一侧椎动脉起始段(V1)不同程度狭窄,其中2例闭死;3/(2/58)椎动脉第二段(V2)迂曲;17/(10/58)颅内段椎-基底动脉狭窄或分支减少。颅脑MRI:脑干、小脑、枕叶共发现梗死灶52个,其中38/为新鲜梗死灶,其余为陈旧性梗死(包括腔隙性梗死);新鲜梗死灶中腔隙性梗死灶60/(12/20),责任病灶75/(9/12),均位于脑桥、延髓、小脑,40/(8/12)新鲜病灶为无关病灶。结论核磁共振在后循环缺血诊断、诊疗中具有一定的应用价值。

The Applicable Value of Magnetic Resonance in the Diagnosis and Treatment for Patients with Posterior Circulation Ischemia

Objective To investigate the applicable value of Magnetic Resonance in the diagnosis and treatment for patients with posterior circulation ischemia (PCI). Methods The clinical and radiological data from 58 patients with posterior circulation ischemia were analyzed retrospectively. Results 69% patients with PCI were found with cervical bone degeneration in different degrees. Vertebrobasilar artery (VBA) imaging showed that 82% patients with PCI had asymmetry vertebral arteries (VA), of which 24% had different degree stenosis in the branch Of VA and 3% had an occlusion of VA. There were 52 infarctions observed in brain stem, cerebellum, and occipital lobar. of them, 38% were fresh and 62% were dated. Among the fresh infarctions, 75% were responsive. Conclusion MR was playing an important role in diagnosis and treatment for PCI.