夹层动脉瘤与缺血PPT课件.ppt

CASE5 CASE5 CASE5 CASE5 CASE6 Dissection of the ICA. a, Conventional angiography initially demonstrated a tapered stenosis of the ICA distal to the bifurcation. b, Baseline 2D TOF MRA obtained 2 days later revealed concordant evidence of a tapered stenosis. c, Follow-up 2D TOF MRA obtained 5 months later had normalized. Dissection of the vertebral artery. a, Conventional angiography showed a well-defined dissection with a prominent intimal flap, mural hematoma, and luminal irregularity. b, Baseline 3D phase-contrast MRA showed a nonspecific flow abnormality in the midvertebral artery with associated luminal irregularity consistent with the diagnosis of dissection. c, Follow-up 3D phase-contrast MRA obtained 3 months later revealed a normal vertebral artery. Left carotid dissection with tapered long stenosis on conventional angiography (top). The external diameter of the carotid artery is enlarged on helical CT (bottom), and the arterial lumen appears eccentric (arrow) because of the arterial wall thickening (mural hematoma; arrowhead). The level of the CT slice is indicated on the angiogram (arrow).  Internal carotid artery (ICA) dissection with aneurysm at the upper portion of the right ICA on angiography (top) and helical CT findings (bottom) showing both narrowed eccentric lumen (arrow) and aneurysm (arrowhead). Typical target CT picture of dissection of the left internal carotid artery associating an arterial wall thickening (straight arrow) and a narrowed eccentric lumen (arrowhead) surrounded by a thin annular contrast enhancement (curved arrow). Occlusive type dissection of the left internal carotid artery (ICA) on angiography (top) and helical CT (bottom) with increased external diameter (arrow) of the ICA compared with the contralateral site (arrowhead). The measurements were made just below the petrous bone. MRI 壁间血肿:发病1周~2个月T1加权像及质子像可见动脉壁呈新月状、曲线状、带状、点状或环状高信号(信号高低取决于出血时间及血肿大小),典型伴中心或偏心流空现象,称双腔征,属直接征象,可作为诊断确切依据 No To Shinkei,2002,54:2032211. MRI T2加权