河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (8): 961-966.doi: 10.3969/j.issn.1007-3205.2023.08.017

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健康人颅内椎-基底动脉系统解剖及变异的3.0T MRA研究

  

  1. 1.河北医科大学第一医院放射与核医学科，河北 石家庄 050030；2．河北医科大学第二医院医学影像科，河北 石家庄 050004

  • 出版日期:2023-08-25 发布日期:2023-08-28
  • 作者简介:王宁（1989-），男，河北邯郸人，河北医科大学第一医院主治医师，医学硕士，从事医学影像诊断研究。
  • 基金资助:
    河北省自然科学基金项目（H2020206491）

Anatomical features and variations of intracranial vertebrobasilar system in the healthy subjects: An analysis with 3.0T MRA

  1. 1.Department of Radiology and Nuclear Medicine, the First Hospital of Hebei Medical University, 
    Shijiazhuang 050030, China; 2. Department of Medical Imaging, the Second hospital of 
    Hebei Medical University, Shijiazhuang 050004, China

  • Online:2023-08-25 Published:2023-08-28

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摘要： 目的 应用3.0T磁共振血管成像（magnetic resonance angiography，MRA）探究健康人群椎-基底动脉系统（vertebrobasilar system，VBS）的正常解剖特点、变异类型及其之间的关系。
方法 采集120例健康志愿的MRA原始图像进行最大密度投影（maximum intensity projiection，MIP）重建，观察并记录VBS的正常解剖和变异，测量各血管管径并进行分析。
结果 健康人群正常VBS占25%，各种变异类型有小脑后下动脉（posterior inferior cerebellar artery，PICA）、小脑下前动脉（anterior inferior cerebellar artery，AICA）、后交通动脉（posterior communicating artery，PCoA）缺如， AICA、小脑上动脉（superior cerebellar artery，SCA）重复变异，右侧双起源小脑后下动脉（double origin of the posterior inferior cerebellar artery，DOPICA）、SCA过早分叉、SCA起源异常、椎动脉发育不全（vertebral artery hypoplasia，VAH）、胚胎型大脑后动脉（fetal posterior cerebral artery，fPCA）、基底动脉（basilar artery，BA）开窗畸形等。男性BA、右侧PCA管径较女性稍粗（P＜0.05），余各血管管径在性别差异无统计学意义（P＞0.05）。各种变异类型中PICA缺如最常见，右侧多于左侧（P＜0.05）；一侧PICA或AICA缺如与存在时相比，同侧AICA或PICA发育良好或发育中等的比率大（P＜0.05）。VAH右侧多于左侧（P＜0.05）。双侧PCoA开放情况在＜45岁组较≥45岁组开放率高（P＜0.05）。
结论 VBS的解剖变异常见、变异类型多，部分缺如血管之间存在代偿关系，PCoA开放情况与年龄相关，这些变异应在脑血管性疾病诊治过程中引起重视。


关键词: 基底动脉, 磁共振血管造影术, 解剖

Abstract: Objective To analyze the normal anatomical features of vertebrobasilar system (VBS), variation types and their relationship in the healthy subjects by 3.0T magnetic resonance angiography (MRA). 
Methods The original MRA images of 120 healthy volunteers were collected for maximum intensity projection (MIP) reconstruction, and normal anatomical features and variations of VBS were observed and recorded. The diameters of branches of VBS were measured and analyzed. 
Results Normal VBS accounted for 25% in healthy people. Types of variation included absence of the posterior inferior cerebellar artery (PICA), the anterior inferior cerebellar artery (AICA) and the posterior communicating artery (PCoA), repeated mutation of AICA and superior cerebellar artery (SCA), double origin of the posterior inferior cerebellar artery (DOPICA) on the right side, early bifurcation of SCA, anomalous origin of SCA,vertebral artery hypoplasia (VAH)，fetal posterior cerebral artery (fPCA) and basilar artery (BA) fenestration. The diameters of BA and right PCA of males were greater than those of females (P＜0.05), but there were no statistically significant difference in diameters of other blood vessels in different genders (P＞0.05). The most frequent variation was absence of the PICA, and absence of right PICA was more frequent than left PICA (P＜0.05). In cases with absence of PICA or AICA on one side, the proportion of well-developed or moderately-developed ipsilateral AICA or PICA was higher (P＜0.05). The VAH was more frequent on the right side (P＜0.05). The patency rate of bilateral PCoA in <45-year-old group were higher than ≥45-year-old group (P＜0.05). 
Conclusion The anatomical variation of the VBS is common and diverse, there is a compensatory relationship between several absent vessels, and the patency of PCoA is associated with age. These variations should warrant attention in the diagnosis and treatment of cerebrovascular diseases. 


Key words: basilar artery, magnetic resonance angiography, anatomy

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