头颈部动脉夹层MSCTA 特征及发病危险因素分析.docVIP

头颈部动脉夹层MSCTA特征及发病危险因素分析 牟凤群 陈通1 刘海霞 (河北省唐山市工人医院神经内科 河北联合大学附属医院神经外科1 邮编063000) 摘要 目的 对比分析颈内动脉夹层（ICD）和椎基底动脉夹层(VAD) 的MSCTA特征表现及相关发病危险因素有无差异。材料与方法 对35例经数字剪影血管造影（DSA）证实的CAD患者的临床及MSCTA资料进行回顾性分析。将患者分为颈内动脉夹层（ICD）和椎基底动脉夹层(VAD) 两组，对比分析两组MSCTA特征表现及相关发病危险因素。结果 头颈部动脉夹层累及38支血管，其中ICD20例，病变血管22支（57.9%），VAD15例，病变血管16支（42.1%），3例（8.6%）患者同时存在2支血管段夹层。ICD中出现双腔征和内膜瓣者较VAD多见，P﹤0.05，瘤样扩张、珠线征VAD组较ICD多见，P﹤0.05。锥状狭窄闭塞两组无统计学差异，P0.05。ICD组发病年龄高于VAD组，P=0.000，两组其余常见发病危险因素包括性别比、外伤、糖尿病、高血压、高脂血症、感染方面均无统计学差异，P0.05。结论 除年龄以外， ICD和VAD具有相似的发病危险因素，ICD和VAD具有不同的MSCTA征象，对明确诊断具有重要价值。 关键词 夹层 头 颈动脉 体层摄影术 X线计算机 ’ Hospital, Neurology. Hebei?Joint University Affiliated Hospital, Neurosurgery ,China.) OBJECTIVE: To investigate whether there were statistical differences in imaging features of multi-slice spiral CT angiography and in risk factors in patients of cervicocerebral arterial dissection. METHODS: Patients with cervicocerebral arterial dissection who were confirmed by DSA from January 2004 to January 2012 were analyzed on clinical data and imaging features of multi-slice spiral CT angiography and DSA. The patients were divided into two kinds of group, carotid arterial dissection group and vertebrobasilar arterial dissection group. Contrast analysis of imaging features of multi-slice spiral CT angiography and risk factors on each group independently. RESULTS: Detection 35 patients had cervicocerebral arterial dissection involving 38 blood vessels, 22(57.9%)lesions were located on internal carotid artery and 16（42.1%） lesions were located on vertebrobasilar artery .The pathognomonic features were double lumen, string signal, blunt occlusion, aneurysm expansion and intimal flap. Significant differences (P0.05) were observed in some features including double lumen, intimal flap, string signal and aneurysm expansion ,whereas the imaging feature like blunt occlusion showing no difference (P﹥0.05).The average age was significantly elder in Group ICD than that in Group VAD, while the other risk factors such as s