Multimodal Imaging Research Of Vertebral-Basilar-Internal Auditory Artery Axis In Cervical Vertigo Patients

Objective Observe the morphology characteristics of vertebral-basilar-internal auditory artery axis, and the effect of vertebral artery adjacent structures in cervical vertigo patients, to investigate the pathogenesis of cervical vertigo, and analyze the effect of internal auditory artery.Materials and methods Lesion group was randomly assigned53patients with cervical vertigo, and was performed control study with simple spondylosis patients group (n=37), and healthy volunteers group (n=20).CTA/CE-MRA combined with cervical spine MR,3D TOF MRA, and T2W-3D-TSE techniques were performed on all study population. The morphological characteristics and abnormal rate of vertebral-basilar-internal auditory artery axis and adjacent structure lesions were analyzed in three groups, and thereby investige their correlation with cervical vertigo.Results Vascular axis abnormal rate in lesion group, simple spondylosis patients group, and healthy volunteers group are86.79%(46/53),13.51%(5/37), and15.00%(3/20) respectively, there were statistical difference (all P<0.05) between lesion group and the other two groups. Vertebral artery combined with internal auditory artery abnormal were the most common location (32.10%,17/53). Although, there was no statistical difference of vertebral artery compressed by bone among three groups (P>0.05), vertebral artery sclerostenosis, hypoplastic vertebral artery, abnormality of basilar artery, abnormality of anterior inferior cerebellar artery, and abnormality of internal auditory artery showed statistical difference among three groups (all P<0.05).Logistic regression showed that vertebral artery sclerostenosis, hypoplastic vertebral artery, abnormality of basilar artery, abnormality of internal auditory artery were the independent risk factors of cervical vertigo (all sig value<0.05),and the vertebral artery sclerostenosis played the greatest role in cervical vertigo (B=3.727).The vertebral artery diameter in lesion group, simple spondylosis patients group, and healthy volunteers group were3.83±0.44mm,3.78±0.58mm, and3.01±0.42mm respectively, there was statistical difference between lesion group and the other two groups (both P<0.05). The incidence of cervical spine instability in lesion group and simple spondylosis patients group were39.62%and10.82%, there was statistical difference (χ2=5.378, P=0.020), and the most common site of instability was C3/4, C4/5level (38.10%).The incidence of narrowed foramina thansversarium, osteohypertrophy of uncovertebral joint, and disk herniation were equal in lesion group and simple spondylosis patients group, and there were no significant difference (all.P>0.05).Conclusion CTA/CE-MRA combined cervical spine MR,3D TOF MRA, and T2W-3D-TSE techniques can be used to assese the morphology characteristics of vertebral-basilar-internal auditory artery axis, and the correlation with its adjacent structures. Vascular axis abnormality is important morphological factor, and cervical instability is important dynamic factor of cervical vertigo pathogenesis. Vertebral-basilar-internal auditory artery axis maybe induce vertigo by reducing blood supply of vestibular receptor.