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中华诊断学电子杂志

中华诊断学电子杂志 ›› 2017, Vol. 05 ›› Issue (01) : 8 -11. doi: 10.3877/cma.j.issn.2095-655X.2017.01.002

所属专题： 文献；

影像学诊断研究

颅内椎动脉夹层演变至夹层动脉瘤的影像学特征
栗兵霞1, 赵丽丽1,†(), 陈珩1, 逯蕊2, 程小军3   
  1. 1. 046000　山西医科大学附属长治市人民医院神经内科
    2. 038000　太原，山西医科大学第一临床医学院
    3. 046000　山西医科大学附属长治市人民医院影像科
  • 收稿日期:2016-07-23 出版日期:2017-02-26
  • 通信作者: 赵丽丽
  • 基金资助:
    山西省卫生厅科技攻关项目(2011099)

The imaging features of intracranial vertebral artery dissection evolving into vertebral dissecting aneurysm

Bingxia Li1, Lili Zhao1,†(), Heng Chen1, Rui Lu2, Xiaojun Cheng3   

  1. 1. Department of Neurology, Changzhi People′s Hospital, Changzhi 046000, China
    2. The First Clinical Medical College, Shanxi Medical University, Taiyuan 038000, China
    3. Department of Radiology, Changzhi People′s Hospital, Changzhi 046000, China
  • Received:2016-07-23 Published:2017-02-26
  • Corresponding author: Lili Zhao
  • About author:
    Corresponding author: Zhao Lili, Email:
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栗兵霞, 赵丽丽, 陈珩, 逯蕊, 程小军. 颅内椎动脉夹层演变至夹层动脉瘤的影像学特征[J]. 中华诊断学电子杂志, 2017, 05(01): 8-11.

Bingxia Li, Lili Zhao, Heng Chen, Rui Lu, Xiaojun Cheng. The imaging features of intracranial vertebral artery dissection evolving into vertebral dissecting aneurysm[J]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(01): 8-11.

目的

探讨颅内椎动脉夹层演变为夹层动脉瘤的影像学特征。

方法

回顾性分析1例椎动脉夹层演变至夹层动脉瘤患者的临床及影像资料，并复习相关文献。

结果

患者头痛发作期间，头颅CT显示基底动脉末端动脉瘤可能，头颅磁共振血管成像显示右侧椎动脉近基底动脉汇合处动脉瘤可能，数字减影血管造影(DSA)可见右侧椎动脉线样内膜影，考虑右侧椎动脉夹层。7个月后随访时行DSA显示右侧椎动脉瘤样扩张，考虑右侧椎动脉夹层演变为夹层动脉瘤。

结论

虽然颅内椎动脉夹层患者临床症状好转，但是影像学显示由椎动脉夹层演变为夹层动脉瘤风险较高。所以，对于颅内椎动脉夹层患者，随访及复查是非常必要的。

关键词: 头痛, 椎动脉夹层, 动脉瘤，夹层, 影像学特征
Objective

To explore the imaging features of vertebral artery dissection evolving into vertebral dissecting aneurysm.

Methods

Analyzing the clinical data and image of one patient with the intracranial vertebral artery dissection evolving into vertebral dissecting aneurysm, and the relevant literatures were reviewed.

Results

During the headache, head computed tomography (CT) scan showed a possible arterial aneurysm at the end of basilar artery, the head magnetic resonance imaging (MRI) showed that there was a possible arterial aneurysm at the intersection of right vertebral artery and basilar artery.Furthermore, on the digital subtraction angiography (DSA) image, right vertebral artery had linear intima which meant right artery dissection.Seven months later, DSA image revealed an artery ectasia in right vertebral artery which was considered as the evolution from right vertebral dissection into aneurysm dissecting.

Conclusions

Even though the patient feel better, the risk of vertebral artery dissection evolving into dissecting aneurysm is high.Therefore, for patients with intracranial vertebral artery dissection, follow-up visit and reexamination are necessary.

Key words: Headache, Vertebral artery dissection, Aneurysm, dissecting, Imaging features
图1 椎动脉夹层患者头颅CT平扫图像。见基底动脉末端似略膨大，动脉瘤可疑(箭头所示)
图2 椎动脉夹层患者头颅MRA扫描图像。a图为正位，b图为侧位。见右侧椎动脉近基底动脉汇合处管腔可见梭形膨胀，最宽处管腔直径约4.0 mm，动脉瘤可疑(箭头所示)
图3 椎动脉夹层患者首次DSA图像。a图为正位，b图为侧位。见R-VA血流缓慢，至V4段近BA处血流中断，管腔内可见线样内膜影，考虑夹层(箭头所示)
图4 椎动脉夹层患者7个月后复查DSA图像。a图为正位，b图为侧位。见R-VA-V4段近BA处管腔增粗，局部内膜下有造影剂滞留，考虑夹层动脉瘤(箭头所示)
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