椎动脉发育不良的MRA诊断与分型研究

发布时间：2018-03-08 07:48

  本文选题：椎动脉发育不良　切入点：磁共振血管造影　出处：《新乡医学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的探讨椎动脉发育不良与后循环缺血的关系,研究椎动脉发育不良的MRA初步分型及其临床意义。方法收集2011年5月至2014年3月在南阳中心医院神经内科门诊及住院的患者,选取行头部/颈部MRA检查,同时行颅脑磁共振平扫检查的患者862例。根据椎动脉发育不良诊断标准,分为椎动脉发育不良组80例(观察组),无椎动脉发育不良组782例(对照组),比较两组间后循环TIA及后循环梗死的总发生率,统计分析椎动脉发育不良与后循环TIA和后循环梗死的相关性。通过80例椎动脉发育不良患者的MRA特点和临床资料,对其进行分型,分析不同分型与后循环TIA及脑梗死的相关性。结果在862例患者中,椎动脉发育不良80例,其中右侧54例,左侧26例；后循环TIA 51例,发生率63.75%,后循环脑梗死23例,发生率28.75%,其中前循环缺血表现为6例；其余782例患者中,前循环缺血表现626例,后循环缺血表现156例,发生率19.95%,其中后循环TIA 97例,发生率12.40%；后循环梗死59例,发生率7.54%；两组比较P=0.000,差异具有统计学意义。椎动脉发育不良根据MRA表现分为Ⅳ型,其中Ⅰ型11例,发生后循环TIA 9例,发生率81.82%,脑梗死1例,发生率9.09%；Ⅱ型28例,发生后循环TIA 21例,发生率75.00%,脑梗死5例,发生率17.86%；Ⅲ型24例,发生后循环TIA 15例,发生率62.50%,脑梗死7例,发生率29.17%；Ⅳ型17例,发生后循环TIA 6例,发生率35.29%,脑梗死10例,发生率58.82%。结论(1).椎动脉发育不良与后循环TIA和后循环梗死有明显的相关性,是缺血性脑卒中的危险因素；(2).根据MRA影像学表现,可将椎动脉发育不良分为Ⅳ型,椎动脉发育不良分型越高,发生脑梗死的风险越大。
[Abstract]:Objective to investigate the relationship between vertebral artery dysplasia and posterior circulation ischemia, and to study the MRA classification of vertebral artery dysplasia and its clinical significance. Methods from May 2011 to March 2014, we collected the patients in the Department of Neurology, Nanyang Central Hospital. According to the diagnostic criteria of vertebral artery dysplasia, 862 patients were selected for head / neck MRA examination and brain MRI plain scan. There were 80 cases of vertebral artery dysplasia (observation group) and no vertebral artery dysplasia group (782 cases) (control group). The total incidence of posterior circulation TIA and posterior circulation infarction were compared between the two groups. The correlation between vertebral artery dysplasia and posterior circulation TIA and posterior circulation infarction was statistically analyzed. The MRA characteristics and clinical data of 80 patients with vertebral artery dysplasia were classified. Results among 862 patients, 80 cases had dysplasia of vertebral artery, including 54 cases on right side, 26 cases on left side, 51 cases on posterior circulation TIA, and 23 cases on posterior circulation cerebral infarction. The incidence rate was 28.75%, including 6 cases of anterior circulation ischemia, 626 cases of anterior circulation ischemia and 156 cases of posterior circulation ischemia, of which 97 cases were posterior circulation TIA (12.40%), 59 cases were posterior circulation infarction. Vertebral artery dysplasia was divided into four types according to MRA manifestation, 11 cases of type 鈪，

本文编号：1583006