椎动脉发育不良的螺旋CT血管造影诊断

目的探讨椎动脉发育不良的螺旋CT血管造影(spiralCTangiography,SCTA)表现和临床意义。方法180例临床诊断为椎-基动脉供血不足患者行SCTA检查。造影剂为浓度350mg/100ml的Omnipaque80～100ml,足背静脉注射。流率3ml/s,延迟时间由预扫描确定。层厚、间隔分别为3mm和4.5mm。重建间隔1.5mm。采用多平面容积重建(MPVR)和表面遮盖法重建(SSD),用原始横断面图像测量椎动脉直径。CT显示有椎动脉狭窄者于1周内行DSA检查。结果360根椎动脉中共发现78根(21.7%)有全程狭窄,平均直径1.3mm(1.0～1.5mm)。其中左侧24根,右侧54根。其中有20根同时伴有局限性进一步狭窄。对侧椎动脉合并局部管壁钙化13根(16.7%),合并V1段扭曲20根(25.6%),合并钩椎关节增生压迫11根(14.1%)。DSA检查结果与SCTA完全一致。结论椎动脉发育不良是椎-基动脉供血不足的常见原因之一,SCTA可以确诊并能取代诊断性DSA检查。

Hypoplastic Vertebral Artery:Diagnosis of Spiral CT Angiography

Objective To evaluate the diagnosis of of hypoplastic vertebral artery by spiral CT angiography(SCTA).Methods 180patients with clinical diagnosis of vertebrobasilar insufficiency were undergone spiral CT angiography. For SCTA, 80~100 ml contrastmedium (omnipaque 350 mg/100 ml) was injected into the foot vein at the rate of 3 ml/s. The delay time was selected through a time-density curve made by Smart prep. Collimation thickness was 3mm and the table speed was 4.5mm/s. Reconstruction was done with 1.5mm increments. The SCTA images were postprossed with multiplanar volume reconstructions (MPVR) and shaded surface display (SSD). Original axial images were used to measure the diameter of vertebral artery. DSA was performed for those cases with vertebral artery stenosis within one week. Results Seventy eight (21.7%) unilateral vertebral arteries were diagnosed as hypoplastic vertebral artery,the left in 24 and the right in 54,the average diameter was 1.3 mm(1.0~1.5 mm),among them,opposite artery coexisted with local calcifications in13 cases, with twist in 20 and with compression by luschka joint hyperplasia in 11. The results were corresponding to that of DSA.Conclusion Hypoplastic vertebral artery is one of the popular reasons of vertebrobasilar artery insufficiency , it could be diagnosed by SCTA and should be used generally in clinic to substitute the more invasive DSA inspection.