摘要
目的探讨大脑中动脉成窗变异的发生率及CT血管成像(CTA)特征,提高对该血管变异的认识。资料与方法 2007年11月至2010年1月本院共有2734例患者行头颈联合64层CTA检查,其中14例确诊为大脑中动脉成窗。回顾性分析大脑中动脉成窗的发生率、部位、形态等CTA特征及其合并症。结果 (1)14例患者共15个大脑中动脉成窗,发生率为0.51%(14/2734)。M1段近端成窗12个,占80%;M1段远端成窗2个,占13.3%,均由一支桥血管与M1段远端及M2段近端构成;M1段中部成窗1个,占6.7%。M1段近端成窗中,9个成窗位于大脑中动脉起始部,3个成窗由一支桥血管与M1和A1近端三支血管组成。(2)2个"窗"径较小者(<2 mm)呈孔状,13个"窗"径较大者中,10个分支粗细不等呈"OK"手势样,3个分支粗细大致相同呈"凸透镜"样。(3)1例合并基底动脉成窗,1例合并大脑后动脉成窗,1例合并永久三叉动脉,3例合并颅内其他动脉的动脉瘤。结论 CTA能快速、直观、准确地判断大脑中动脉成窗及其合并症,熟悉其CTA特征有助于指导临床制定合理的治疗方案,提高相应治疗中的安全性。
Objective To analyze the incidence and CT angiography（CTA） features of the fenestrations variation of middle cerebral artery, and to improve dignosis. Materials and Methods The imaging data of 2734 patients performed 64 slice CTA of the cranio cervical arteries in our hospital between November,2007 and January 2010 were evaluated retrospectively, and 14 of them were diagnosed as the fenestration variation of middle cerebral arteries. The incidence, location, morphological characteristics of the fenestration of middle cerebral artery and its coexisting abnormalities were analyzed. Results （ 1 ） 15 fenestrations variation of middle cerebral arteries in 14 patients were found,withh the incidence of 0.51% （14/2734）. 80% （12 fenestrations） were located at the proximal M1 segments, 13.3% （2 fenestrations） at the distal M1 segments, and 6.7% （1 fenestration） at the middle segment of the M1. Among the proximal M1 segments,9 fenestrations located at the origin of the middle cerebral arteries,3 fenestrations were constituted with the proximal segment of A1 and M1 and a bridge vessel. （2） Two small fenestrations （less than 2 mm） presented foramen like. Ten of 13 large fenestrations simulated an ＂ok＂ hand sign, which the branches of fenestration were unequal size,3 showed convex lens like shape, which the branches of fenestration were almost equal size. （ 3 ） One case associated with fenestration of the basilar artery, 1 case associated with fenestration of the posterior cerebral artery, 1 case associated with persistent trigeminal artery, and 3 cases coexisted with aneurysms of other cranial arteries. Conclusion 64 slice CTA of the cranio cervical arteries is a rapid and accurate method for demonstrating middle cerebral artery fenestration variation and its coexisting abnormalities. Diagnosis of this anatomic variation prior to surgery and intervention may be helpful for procedures choice and decreasing the risk of operation.
出处
《临床放射学杂志》
CSCD
北大核心
2011年第3期422-424,共3页
Journal of Clinical Radiology
