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目的探讨椎基底动脉扩张延长症(vertebrobasilar dolichoectasia,VBD)的临床表现及磁共振血管造影(MRA)特点,以提高对VBD的认识。方法对2009年确诊的5例VBD患者的临床资料进行回顾分析,总结其临床表现及MRA特点。结果临床表现多样,常表现为脑干/脑神经压迫症状、缺血性中风、脑积水等。头颈MRA可见增粗、延长、迂曲的椎基底动脉及基底动脉移位、扩张、压迫脑干。基底动脉直径>4.5 mm,全长>29.5 mm,侧方移位>10 mm。结论VBD多引起椎基底动脉缺血、脑干/脑神经受累症状。头颈MRA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诊断的首选方法之一。
Objective To investigate the clinical manifestations of vertebrobasilar dolichoectasia (VBD) and the characteristics of magnetic resonance angiography (MRA) in order to improve the understanding of VBD. Methods The clinical data of 5 patients with VBD diagnosed in 2009 were retrospectively analyzed, and their clinical manifestations and MRA features were summarized. Results of various clinical manifestations, often manifested as symptoms of brainstem / cranial nerve compression, ischemic stroke, hydrocephalus and so on. Head and neck MRA visible thickening, prolonged, tortuous vertebrobasilar artery and basilar artery displacement, expansion, oppression of the brainstem. Diameter of basilar artery> 4.5 mm, total length> 29.5 mm, lateral displacement> 10 mm. Conclusions VBD often causes vertebrobasilar ischemia and brainstem / cranial nerve involvement symptoms. Head and neck MRA can accurately and clearly show the morphological changes of vertebrobasilar artery, calcification of the vascular wall and the relationship with the surrounding structure, which can be used as one of the preferred methods of diagnosis of VBD.