The Correlation On MR Of Vertebral Artery Dominance,Basilar Artery Tortuosity And Posterior Circulation Infarction

ObjectiveTo explore the relationship between unilateral VAD,the BA tortuosity,and PCI.To improve the understanding of vascular etiology in patients with PCI,to further clarify pathogenesis of the BA tortuosity caused by VAD,and PCI.For the patients who have VAD and BA tortuosity provide new ideas for prevention of PCI.MethodsContinuous collection in October 2015-November 2016 in the Second Affiliated Hospital of Dalian Medical University,the clinical manifestations of PCI,and patients with non cerebrovascular disease at the same time,a total of 218.Data processing is divided into the following parts:1.The study was divided into two groups,according to the results of MRA: VAD group(n = 162)and non VAD group(n = 56),to analyze and compare the differences between the two groups.2.In group VAD,to analyze the correlation of VAD direction side,BA tortuosity direction,and the shape of BA tortuosity.3.The 93 patients,who have both VAD and BA tortuosity,were divided into 3levels according to the measurement results of VA diameter difference,while thedetermination of bending length(BL)was also divided into 3 levels.To analyze the differences of BL Layered in patients who have VAD and BA tortuosity.4.In VAD group,90 patients with PCI,non VAD group,patients with PCI is 12 cases.The difference between the two groups was compared in the infarction rates of the posterior circulation and various brance parts.5.In the VAD group,to analyze and compare the relationship between the direction of VAD and the direction side of PCI.6.In 218 patients,116 cases of BA tortuosity,they would be divided into the BA tortuosity in 80 patients with cerebral infarction,36 cases of BA tortuosity of non cerebral infarction group,the data would be compared between the two groups.7.218 patients were divided into groups of 116 cases with BA tortuosity and 102 cases with BA non tortuous,to analyze and compare the relationship between BA tortuosity and each part of the infarction rates of posterior circulation.Results1.In group VAD,57.4%(93/162)in patients with BA tortuosity,while in the non VAD group,only 41.1%(23/56)in patients with BA tortuosity.VAD group compared with non VAD group,?2=4.461,(P<0.05),the difference was statistically significant.2.VAD group of 162 patients,there are 93 cases of BA tortuosity,74.2%(69/93)of the patients,with BA to contralateral VAD occurred tortuous,BA tortuosity occurs towards other side of VAD.It has the correlation between the dominant side of VAD and the BA tortuosity direction,appearing negative correlation.3.Comparison between different levels of BL,the diameter difference between bilateral VA was related to BL,appearing positive correlation(r=0.236,P=0.023)?4.The incidence of PCI in VAD group was significantly higher than that in non VAD group(55.6%(90/162)vs.21.4%(12/56),?2=19.467,P=0.000)?The difference between the two groups in the incidence of cerebral infarction,it was statistically significant in both posterior inferior cerebellar artery(PICA)and BA areas,while there was no significant difference in the rest.5.In group VAD,24 patients with PICA infarction,18 cases(75%,18/24)occurred on the non dominant side.41 patients with cerebral infarction in BA area,there were 34cases(82.9%,34/41)of infarction occurred on the VAD side.7 patients with superior cerebellar artery(SCA)infarction,4 cases of infarction occurred on the VAD side,while3 cases in non VAD side.18 patients with posterior cerebral artery(PCA)infarction,10 cases of infarction occurred on the VAD side,while 8 cases in non VAD side.6.The comparation between cerebral infarction group and non cerebral infarction group of BA tortuosity,it was found that there was a significant difference between the two groups in VAD,P<0.05.7.The comparation between BA tortuosity group and BA non tortuous group,there was significant difference in the incidence of cerebral infarction in posterior circulation system,the incidence of infarction in PICA and BA area was also statistically significant,and there was no significant difference in other parts.Conclusions1.VAD easily led to the occurrence of BA tortuosity and PCI.BA tortuosity was easy to occur towards contralateral to VAD.There was a positive correlation between the diameter difference of bilateral VA and BL.2.Patients with VAD were prone to cerebral infarction in PICA and pontine branch of BA areas.The location of infarction in PICA area was mostly located on the contralateral side of VAD,just BA bending side,while the BA pontine branch territory infarction occurred in the VAD side,on the opposite side of the BA tortuous.3.BA tortuosity exposed in vascular risk factors of VAD,increased the likelihood of PCI occurrence.BA tortuosity more easily caused PCI,especially in PICA and BA pontine branch areas.