MSCT Evaluation Of The Relation Between Vertebral-basilar Insufficiency And Vertebral Artery And Its Neighboring Structure

Objective: To explore the value of multi-slice computed tomography in evaluating the relationship between vertebral-basilar insufficiency and vertebral artery and its neighboring structure. Materials and methods: Between April 2007 and April 2008, 92 patients received plain and enhancement scan of computed tomography of vertebral artery in the first affiliated hospital of Kunming Medical College. All of them (50 men and 42 women; 84 right-handed persons and 8 left-handed persons; age range, 34-76year;mean age, 50.6 years) were divided into three groups: the first group included the patients who didn't show any symptom of vertebral-basilar insufficiency; the second group included the patients who were verified as vertebral-basilar insufficiency by reason of vertebral artery disease by clinical doctors and radiologists; the third group included the patients who were verified as vertebral-basilar insufficiency by reason of disease of the neighboring structure of vertebral artery,this group was again divided into two groups according to symptom of sympathetic nervous. All patients underwent CT scan and post reconstruction according to standard examine program. Meanwhile, dimensions, area and ratio between transverse foramen area and vertebral artery area were measured. Results: Among all patients, 28 patients (30.43%) were found of three kinds of variation. An abnormal level of entrance was observed in 26.09% of specimens (24 cases). Vertebral artery sulcus ring of atlas was found in 2.17% of specimens (2 cases). Besides ,an abnormality of vertebral artery tortuous course below the posterior arch of the atlas was found in 2.17% of specimens (2 cases). The measurement of transverse foramen and vertebral artery showed that transverse foramen was smaller and smaller from C1 to C7.Besides, the right transverse foramens and vertebral arteries of right-handed persons were smaller than the left, but the left-handed persons showed the opposite conclusion. The ratio between transverse foramen area and vertebral artery area of vertebral-basilar insufficiency patients with symptom of sympathetic nervous were larger than normal group and the other patients of the third group without symptom of sympathetic nervous was smaller than normal group. Among the second group, atherosclerosis, arteritis and trauma were found to be relation with vertebral-basilar insufficiency, respectively in 83.33 % (n=20), 8.33 % (n=2),8.33 %(n=2).Conclusion: Firstly, Post reconstruction techniques of MSCT and original image are accurate and sensitive in studing the relationship between vertebral-basilar insufficiency and vertebral artery and its neighboring structure. Secondly, MSCT could ensure the exact etiology of every person of vertebral-basilar insufficiency Such as the disease of vertebra artery and its neighboring structure of transverse foramen and sympathetic nervous. Thirdly, MSCT could be used to quantify the degree of vertebral-basilar insufficiency. Eventually, MSCT could be used to study the difference of bilateral vertebral artery's diameter between right-handed persons and left-handed persons.