Study Of Imaging Of Posterior Circulation Ischemic

PART1STUDY OF INTRACRANIAL SEGMENT OFVERTEBRAL ARTERY AND BASILAR ARTERY ON VOLUMECOMPUTED TOMOGRAPHY DIGITAL SUBTRACTIONANGIOGRAPHYSECTION1STUDY OF INTRACRANIAL SEGMENT OFVERTEBRAL ARTERY ON VCTDSAObjective: To study the travelling and anatomical variations ofintracranial segment of vertebral artery on VCTDSA and to investigate therelationship between the posterior communicating artery (PCoA) and thedevelopment of intracranial segment of vertebral artery.Methods: A total of110normal subjects underwent cerebral andcervical vessel VCTDSA were involved in this study and images ofintracranial segment of vertebral arteries were observed and measured byVR images. The development of vertebral artery, isolating vertebral artery,the state of PCoA，fetal posterior cerebral artery were observed. Diameter of intracranial segment of vertebral artery was measured. Correlation betweendevelopment of vertebral artery and state of PCoA were analyzed. Therewas significant difference when P<0.05.Results:①In110cases, isolating vertebral artery and hypoplasticvertebral artery were respectively in1.82%(2/110)and17.27%(19/110).The number of the vertebral artery running straight and more than3numberof tortuous were50.00%(55/110) and0.91%(1/110).Left and right diameterintracranial segment of vertebral artery were respectively in (3.74±0.91)mmand(3.30±0.90)mm.②29patients with single or bilateral posteriorcommunicating artery developed, among them20cases with bilateraldeveloped,5cases with single development.③The developing of PCoAwas correlation with the development of intracranial segment of vertebralartery(r=0.44,P=0.000).Conclusion: The hypoplasia of intracranial segment of vertebral arteryleads to compensatory posterior communicating artery developing.VCTDSA can clearly demonstrate the anatomy and variability of segmentof vertebral artery, and its anatomic valuable reference for diagnosis ofcerebral diseases. SECTION2STUDY OF BASILAR ARTERY ON VCTDSAObjective: To investigate the anatomical variations and travelling ofbasilar artery on VCTDSA and to investigate the relationship between thebasilar artery bending and the development of intracranial segment ofvertebral artery.Methods: A total of110normal subjects underwent cerebral andcervical vessel VCTDSA were involved in this study and images of basilararteries were reconstructed by VR images. The development of vertebralartery, window variation and tortuosity of basilar artery were observed. Thediameter and length of basilar artery were measured. Correlation betweendevelopment of vertebral artery and tortuosity of basilar artery wereanalyzed. There was significant difference when P<0.05.Results:①In110cases, hypoplastic vertebral artery, tortuosity andwindow variation of basilar artery were respectively in17.27%(19/110),22.73%(25/110)and3.64%(4/110).②The length and diameter of basilarartery were respectively in (28.25±3.88)mm and (3.86±0.54)mm.③Thetortuosity and window variation of basilar artery was correlation with thedevelopment of intracranial segment of vertebral artery（r=0.52,P=0.000）.Conclusion: The hypoplasia of intracranial segment of vertebral arteryleads to tortuosity of basilar artery. VCTDSA can clearly demonstrate theanatomy and variability of basilar artery, and its anatomic valuablereference as diagnosis of cerebral diseases. PART2STUDY OF THE IMAGING AND RELATED SYMPTOMS OFPOSTERIOR CIRCULATION ISCHEMICObjective: To investigate the changes of intracranial segment ofvertebral artery and basilar of artery dizziness or vertigo of posteriorcirculation ischemic on VCTDSA. To investigate the diagnostic value ofVCTDSA in dizziness or vertigo of posterior circulation ischemic，toprovide imaging evidence for clinical.Methods: Cerebral and cervical vessel VCTDSA scan of218cases ofdizziness or vertigo of posterior circulation ischemic patients from January2010to December2011in our hospital were collected as PCI group，cerebral and cervical vessel VCTDSA scan of other patients withoutcirculation ischemia of110cases were collected as control group. Thedevelopment of vertebral artery, isolating vertebral artery, tortuosity andluminal thickness uniformity, stenosis or occlusion of vertebral artery andbasilar artery, fetal posterior cerebral artery were observed. The diameter ofintracranial segment of vertebral artery, the diameter and length of basilarartery and angle of tortuous artery were measured. The tortuous rating was determined according to the number and angle of tortuosity of bilateralvertebral arteries and basilar artery. The rating of tortuosity of the vertebraland basilar artery≥the number of class III were counted respectively.Statistical testing was performed by SPSS17.0and there was significantdifference when P<0.05.Results:①In110cases of control group, isolating vertebral artery andhypoplastic vertebral artery were respectively in1.82%(2/110)and17.27%(19/110). The number of the vertebral artery running straight andmore than3number of tortuous were50.00%(55/110) and0.91%(1/110);In left vertebral artery tortuosity rating level, Ⅰlevel and more than Ⅲwere respectively in66.4%(73/110) and only3.6%(4/110). In right vertebralartery tortuosity rating level, level and more than Ⅲ were respectively60.00%(66/110) and only6.36%(7/110). Left and right diameter intracranialsegment of vertebral artery were respectively in (3.74±0.91)mm and(3.30±0.90)mm. In218case of PCI group, Isolating the vertebral artery andhypoplastic vertebral artery were respectively in10.55%(23/218)and49.08%(107/218).The number of the vertebral artery running straight andmore than3number of tortuous were6.4%(14/218)and79.4%（173/218）;Inleft vertebral artery tortuosity rating level,Ⅰlevel and more than Ⅲ wererespectively in18.81%(41/218)and72.94%(159/218). In right vertebralartery tortuosity rating level, level and more than Ⅲ were respectively20.64%（45/218） and74.77%(163/218).②In110cases of control group, the length and diameter of basilar artery were respectively in(28.25±3.88)mm and (3.86±0.54)mm. The number of the basilar arteryrunning straight and tortuous were respectively in77.27%(85/110) and22.73%(25/110). In basilar artery tortuosity rating level, Ⅰlevel and morethan Ⅲ were respectively in77.27%(85/110) and only0.91%(1/110). In218case of PCI group, The length and diameter of basilar artery wererespectively in (29.76±4.31)mm and (3.78±0.72)mm. The number of thebasilar artery running straight and tortuous were respectively in48.62%(106/218) and51.37%(112/218). In basilar artery tortuosity rating level,Ⅰlevel and more than Ⅲ were respectively in48.62%(106/218) and18.81%(41/218).③The fetal posterior cerebral artery of control group andPCI group were7.27%(8/110) and28.90%（63/218） respectively.④Isolating vertebral artery，the development of vertebral artery, number andrating level of tortuosity of vertebral artery, the length basilar artery, ratinglevel of tortuosity of basilar artery, luminal thickness uniformity of tortuosityof vertebral artery and fetal posterior cerebral artery consists significantdifference between normal group and PCI group, but the diameter ofvertebral artery and basilar artery between two group were no difference.⑤Logistic regression indicated that dizziness or vertigo of posteriorcirculation ischemic associated with the development of vertebral artery,tortuosity of vertebral artery(B=5.07，Sig=0.000) and luminal thicknessuniformity of tortuosity of vertebral artery(B=2.73, Sig=0.000） and development of intracranial segment of vertebral artery(B=1.63,Sig=0.000).Conclusions:①Isolated vertebral artery, bilateral vertebral arterydevelopment, number and rating tortuous of bilateral vertebral arterytortuosity, the length of the basilar artery, tortuosity and rating tortuous ofbasilar artery, luminal thickness uniformity， stenosis or occlusion ofvertebral artery and basilar artery, fetal posterior cerebral artery associatedwith dizziness or vertigo symptoms of posterior circulation ischemia, thetortuosity of the vertebral artery (B=5.07，Sig=0.000)was most dangerousfactor.②VCTDSA could provide detailed anatomy information, to providea basis for diagnosis and treatment of dizziness or vertigo symptoms ofposterior circulation ischemic.