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背景:椎基底动脉供血不足的血管结构异常有助于对病因的认知和理解,对血管结构异常的分型可以使诊断规范化、系统化。目的:探讨椎基底动脉供血不足患者血管异常的影像学特点、分型及临床意义。设计:以诊断为依据的非对照研究。地点和对象:1999-01/2002-12青岛市市立医院门诊及病房椎基底动脉缺血患者33例,男23例,女10例。干预:椎基底动脉供血不足患者进行数字减影血管造影(DSA)或磁共振血管造影(MRA)检查,对发现的33例血管异常者进行系统分析,并将其尝试性地进行分型。主要观察指标:椎基底动脉系统血管结构异常分型。结果:将椎基底动脉结构异常分为锁骨下动脉型、椎动脉型、基底动脉型和大脑后动脉型4个类型,每型又分为2～5个亚型。椎动脉型是椎基底动脉供血不足患者血管结构异常的主要类型,占61%,其次为基底动脉型、锁骨下动脉型和大脑后动脉型。结论:椎动脉血管结构异常是最常见的导致椎基底动脉缺血的血管性病因。血管结构异常因其成因、年龄等因素影响表现出不同的病变类型。
BACKGROUND: Abnormal blood vessels in vertebrobasilar insufficiency contribute to the cognition and understanding of etiology. The classification of abnormal vascular structures can make the diagnosis standardized and systematic. Objective: To investigate the imaging features, classification and clinical significance of vascular abnormalities in patients with vertebrobasilar insufficiency. Design: Diagnostic-based, uncontrolled study. Location and Subjects: From January 1999 to December 2002, 33 cases of outpatient and ward vertebrobasilar ischemia in Qingdao Municipal Hospital were included, 23 males and 10 females. INTERVENTIONS: Digital subtraction angiography (DSA) or magnetic resonance angiography (MRA) was performed in patients with vertebrobasilar insufficiency. Systematic analysis of the 33 patients with vascular abnormalities was performed and tentatively typed. MAIN OUTCOME MEASURES: Vascular structural abnormalities of vertebrobasilar system. Results: The structural abnormalities of vertebrobasilar artery were divided into subclavian artery type, vertebral artery type, basilar artery type and posterior cerebral artery type. Each type was divided into 2 ~ 5 subtypes. Vertebral artery type is the main type of vascular structural abnormalities in patients with vertebrobasilar insufficiency, accounting for 61%, followed by basilar artery, subclavian artery and posterior cerebral artery. CONCLUSIONS: Vascular structural abnormalities of the vertebral artery are the most common vascular causes of vertebrobasilar ischemia. Vascular structural abnormalities due to its causes, age and other factors show different types of lesions.