Observation And Study On Consistency Of Atlantoaxial Vertebral Vascular Structure And Vertebral Artery

Objective To measure and count the transverse diameter,sagittal diameter and vertebral artery diameter of atlantoaxial transverse foramen by using multi-slice spiral CT angiography technology(CTA),to analyze the correlation between atlantoaxial transverse foramen and vertebral artery and variation situation of vertebral artery and to discuss the prevention strategies of vertebral artery injury.Methods In our hospital,from July 2017 to July 2018,the data of all patients who had undergone cervical CTA were collected.They were divided into two groups.Group A: normal control group,group B: occipitocervical malformation group(including atlantoaxial dislocation or instability,occipitalization of atlas,skull base depression,cerebellar tonsillar hernia).The transverse diameter,sagittal diameter and vertebral artery diameter of atlantoaxial transverse foramen were measured on the axial position.For all data,the measurement was completed on PACS system of imaging department.Results(1)In group A,the left lateral diameter of C1 was 6.71±0.43 mm,the sagittal diameter was 6.99±0.46 mm,the right lateral diameter was 6.45±0.43 mm,the sagittal diameter was 6.62±0.58 mm,the left lateral diameter of C2 was 7.05±0.40 mm,the sagittal diameter was 6.68±0.43 mm,the right lateral diameter was 6.61±0.53 mm,and the sagittal diameter was 6.45±0.44m;The left vertebral artery diameter of C1 was3.98±0.24 mm,right vertebral artery was 3.65±0.26 mm,left vertebral artery of C2 was 3.89±0.22 mm,right vertebral artery was 3.61 0.31 mm.In group B,left lateral diameter of C1 was 6.21±0.97 mm,sagittal diameter was 6.71±1.07 mm,right lateral diameter was 6.17±0.76 mm,sagittal diameter was 6.67±0.84 mm,left lateral diameter of C2 was 6.80±0.77 mm,sagittal diameter was 6.39±0.76 mm,right lateral diameter was 6.47±0.53 mm,sagittal diameter was 6.16±0.45mm;In group B,the left vertebral artery diameter of C1 was 3.24±1.17 mm,the right vertebral artery diameter of C1 was 2.53±0.93 mm,the left vertebral artery diameter of C2 was 3.21±1.13 mm,and the right vertebral artery diameter of C2 was 2.55±0.96 mm.(2)In group A and group B,the transverse diameter and sagittal diameter of the transverse foramen on the left side were larger than those of the transverse foramen on the C1-C2 level.Moreover,the difference was statistically significant(all P < 0.05).The sagittal diameter of transverse foramen on the same side of atlas was larger than transverse diameter of transverse foramen(p < 0.05).The transverse diameter of the ipsilateral transverse foramen of axis was larger than the sagittal diameter(P < 0.05).(3)On the atlantoaxial level,the diameter of the left vertebral artery was larger than that of the right vertebral artery.Moreover,the difference was statistically significant(all p <0.05).(3)The diameter of vertebral artery in group A was linearly related to the transverse diameter of transverse foramen(Pearson=0.684).Correlation difference between sagittal diameter of transverse foramen and vertebral artery diameter(Pearson = 0.174);In group B,the transverse diameter and sagittal diameter of transverse foramen of neck 1-2 had no significant correlation with vertebral artery diameter at corresponding levels(all Pearson<0.3).(4)Compared with group A,the value dispersion coefficient of vertebral artery diameter measured at the same segment and the same side in group B was significantly increased.Compared with theatlantoaxial level caused by occipitocervical malformation was obviously increased.(5)Compared with group A,the variation rate of various vertebral arteries in group B was significantly increased.The variation rate of group B was 70.0% and that of group A was 25.5%.Conclusion1.The diameter of atlantoaxial vertebral artery in normal population has significant correlation with the shortest diameter of transverse foramen of corresponding level.2.There is no significant correlation between transverse foramen diameter and vertebral artery diameter in the abnormal population of occipitocervical malformation.3.Compared with the normal population,the individual difference and variation rate of vertebral artery in occipitocervical malformation population are larger.