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目的探讨颈部血管彩色多普勒超声、MR血管造影(MRA)对椎基底动脉供血不足病因的诊断价值。方法选取2013年2月至2015年2月辽宁省本溪市中心医院收治的63例椎基底动脉供血不足患者为研究对象,均经临床病理检查确诊,并行颈部血管彩色多普勒超声检查,其中42例患者行椎颈动脉MRA检查,分析彩色多普勒超声及MRA检查情况。结果 63例患者中,经颈部血管彩色多普勒超声检查发现45例(71.4%)存在异常,主要表现为椎动脉闭塞20例,椎动脉扭曲和变细、斑块形成5例,动脉硬化5例;行MRA检查的42例患者中,21例(50.0%)发现异常,主要表现为椎动脉闭塞8例、变细7例、局限性狭窄或者扭曲6例。结论在椎基底动脉供血不足的病因诊断中,颈部彩色多普勒超声在椎动脉内镜、椎动脉壁硬化及动脉血管内附壁血栓的显示上优势显著;MRA能清晰地显示椎动脉狭窄情况,在显示椎动脉整体形态方面优势显著;两者联合能够为椎基底动脉供血不足的病因诊断提供有效的参考信息。
Objective To investigate the diagnostic value of cervical vascular color Doppler ultrasound and MR angiography (MRA) in the etiology of vertebrobasilar insufficiency. Methods Sixty-three patients with vertebrobasilar insufficiency who were admitted to Central Hospital of Benxi, Liaoning Province from February 2013 to February 2015 were selected and confirmed by clinicopathological examination and color Doppler ultrasonography of neck vessels. 42 patients underwent MRA examination of vertebral artery, color Doppler ultrasound and MRA examination. Results Among the 63 patients, 45 (71.4%) were found abnormally by color Doppler ultrasound of the neck vessels. They were mainly vertebral artery occlusion in 20 cases, vertebral artery distortions and degeneration, plaque formation in 5 cases, arteriosclerosis Of the 42 patients who underwent MRA, 21 (50.0%) were found to be abnormal. The main findings were 8 cases of vertebral artery occlusion, 7 cases of narrowing, 6 cases of limited stenosis or distortion. Conclusion In the etiological diagnosis of vertebrobasilar insufficiency, neck color Doppler ultrasound has obvious advantages in vertebral artery endoscopy, vertebral artery wall sclerosis and arterial wall mural thrombus; MRA can clearly show the vertebral artery stenosis Situation, in the display of the overall morphology of vertebral artery has obvious advantages; the combination of the two vertebral basilar artery can provide an effective reference for the diagnosis of etiology.