椎基底动脉扩张延长症临床及CTA分析

目的：探讨椎基底动脉扩张延长症（Vertebrobasilar dolichoectasia，VBD）的临床表现及CT血管造影（CTA）的特点，加深对该种少见病的认识。方法：对我院2007年7月～2008年7月确诊的5例VBD患者进行回顾性分析，探讨其临床表现及CTA特点。结果：头晕为主要临床表现。部分可表现为眩晕；VBD还可以引起周围性面瘫、短暂性脑缺血发作及不全闭锁综合征。头颈CTA可见增粗、延长、迂曲的椎基底动脉及管腔、管壁内钙化斑，以及基底动脉移位、扩张、压迫脑干。结论：VBD无特异性临床表现，更多引起椎基底动脉缺血症状、脑干梗死及脑神经损害。头颈CTA能准确清晰地显示变异的椎基底动脉的立体形态、血管壁钙化以及与周围结构的关系，可以作为VBD诊断的首选检查方法。

A Clinical and CTA Analysis of Vertebrobasilar Dolichoectasia

Objective：To explore the clinical features and the Computed Tomography Angiography（CTA） features of vertebrobasilar dolichoectasia （VBD）, and strengthen the recognization of the rare disease. Methods： The clinical data of 5 patients with V-BD diagnosed during 2007.7- 2008.7 in our hospital were analyzed retro- spectively. To explore their clinical symptoms and CTA features . Results： Dizziness were the mainly clinical manifestations and vertigo partly; VBD may cause peripheral facial paralysis , transient ischemic attack and Locked- In syndrome. Vertebrobasilar which was thickening, tortuous and extended was showed on the head and neck of CTA, and calcium spot in the vascular wall and endovascular was also showed . The brainstem was compressed by the basilar artery shifting and expending. Conclusion： VBD had not special clinical features. It caused mainly vertebrobasilar ischemic symptoms , brainstem infarction and cranial nerves damaged. The CTA could clearly and accurately show the variation three - dimensional form of vertebral basilar artery which was varitant , as well as calcified vessel wall and the organizational structures around the vessel . It is the preferred means to diagnose VBD.