椎动脉三维CT血管成像的应用及临床意义

目的：探讨椎动脉型颈椎病患者椎动脉三维CT血管成像的影像学特征及其临床意义。方法：86例拟诊为椎动脉型颈椎病患者接受椎动脉三维CT血管成像(three-dimensional CT angiographic imaging,3D-CTA)检查，重建椎动脉和颈椎骨及颅内椎-基底动脉，在CTA上观察椎动脉的外形、行经及与颈椎骨的关系。结果：86例患者的椎动脉CTA重建图像中血管先天畸形15例，血管硬化21例，骨质增生或纤维组织增生致血管局部受压38例，血管闭塞1例，血管瘤1例；椎动脉正常10例。先天畸形中发育异常9例，表现为整条血管纤细，直径小于2．5mm；走行异常6例。血管硬化表现为血管壁粗糙、不规则、粗细不均匀、钙化等。结论：CTA诊断椎动脉先天畸形和血管硬化有独到之处，椎动脉先天畸形和血管硬化是椎动脉型颈椎病发病的重要因素之一。

The Clinical value of three-dimensional CT angiographyic (3D-CTA) imaging of vertebral artery

Object ive:To demonstrate the character and result of3D-CTA imaging of vertebral artery in cervical spondylosis at the origin of the vertebral artery.Method:86cases s uspected as vertebral artery insufficiency of cervical spondylosis were examined by3D-CTA.The imaging of3D-CTA showed the vertebral artery,cervical bone,intracr anial vertebrobasilar artery and their relationship.Result:The3D-CTA imaging of 86cases displayed the lesions consisted of15congenital abnormalities,21sclerosis ,38local compression,1occlusion,1angioma,10normality of the vertebral arteries.9 cases with congenital hypoplastic certebral artery showed general thin of the wh ole vessel and the inner diameter was less than2.5mm.6cases belonged to abnormal ly extended courses in15cases congenital abnormalities.The artery sclerosis show ed rough vascular surface,irregular surface,lumen stenosis,stiffness and calcifi caton.Conclusion:3D-CTA is superior to other angiography method to display cong enital abnormalities and sclerosis of the vertebral artery,and we think that the cogenital abnormalities and sclerosis are the important inducing factors to the cervical spondylosis at the origin of the vertebral artery.