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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

20卷

期数:

2014年02期

页码:

150-153

栏目:

临床医学

出版日期:

2014-03-20

文章信息/Info

Title:

Influence of uncinate process and superior articular process on vertebral artery in CTA image

文章编号:

1006-8147(2014)02-0150-04

作者:

宋 明¹; 万业达²; 何岸苇²; 张 琳²; 刘竞艳²

(1.天津医科大学研究生院,天津 300070;2.天津市天津医院放射科,天津 300211)

Author(s):

 SONG Ming¹; WAN Ye-da²; HE An-wei² ; ZHANG Lin² ; LIU Jing-yan²

(1.Graduate School，Tianjin Medical University，Tianjin 300070，China ；2.Department of Radiology，Tianjin Hospital，Tianjin 300211，China)

关键词:

椎动脉; CT血管成像; 钩突; 上关节突

Keywords:

vertebral artery; CT angiography; uncinate process; superior articular process

分类号:

R445

DOI:

-

文献标志码:

A

摘要:

目的：分析椎动脉与相邻颈椎（C）钩突及上关节突的关系，对钩突增生影响椎动脉的程度进行初步判定。方法：按纳入标准选取行颈CTA检查的患者61例。沿椎动脉走行方向分别对左、右侧椎动脉行多平面重组，在冠状面观察钩突与相邻椎动脉的关系，通过旋转重组后图像的角度得到上关节突的矢状面图像并观察上关节突与邻近椎动脉的关系。C₃～C₇处冠状面测量钩突突向椎动脉最外点到颈椎中线的距离（L）、钩突所在椎体中份宽度一半（M）,并计算L/M值。依据椎动脉移位情况将C₃～C₆处钩突增生程度分为Ⅲ度，Ⅰ度：椎动脉无移位；Ⅱ度：椎动脉移位距离≤2.5 mm；Ⅲ度：椎动脉移位距离＞2.5 mm。 结果：（1）所观察的610处钩突中，因钩突增生对椎动脉造成影响的有68处（11.1%，68/610），以C₆钩突最为多见（48.5%，33/68），C₃钩突最为少见（4.4%，3/68）。上关节突对椎动脉造成影响的共41处（6.7%，41/610），以C₄、C₅上关节突多见（92.7%，33/41），因钩突增生对椎动脉造成影响多于因上关节突增生对椎动脉造成的影响（c²=12,P<0.01）。（2）除C₃之外，C₄～C₇左右侧L/M值无差别。（3）右侧钩突增生程度为I度共140处，L/M值为0.996±0.104；Ⅱ度共13处，L/M值为1.084±0.080；Ⅲ度共11处，L/M值为1.252±0.124。左侧钩突增生程度为Ⅰ度共130处，L/M值为0.980±0.060；Ⅱ度11处，L/M值为1.044±0.056；Ⅲ度15处，L/M值为1.200±0.060，3种程度的增生左右侧钩突个数均无差别。结论：颈部CTA检查可以准确地判定椎动脉与周围骨质结构的关系，钩突增生较关节突增生更易影响椎动脉。L/M的计算可用于判定钩突增生对相邻椎动脉的影响程度。

Abstract:

Objective ：To investigate the relationship between vertebral artery and its adjacent uncinate process as well as superior articular process and to determine the influence of uncinate processes hyperplasia on the vertebral artery. Methods：Sixty one patients were selected who underwent cervical artery CTA，and the CT angiography of the left and right vertebral artery was obtained by the method of multiplanar reconstruction on the direction of the vertebral artery. The relationship between uncinate process and its adjacent vertebral artery was observed on coronal plane. By the rotation angle of the image on the reorganization, sagittal images of the superior articular process was obtained and the relationship between superior articular process and adjacent vertebral artery was observed. The distance of the uncinate processes protruding to the outmost point of the vertebral artery to the midline of the cervical spine was measured on the coronal plane(L)，and half width of the middle part of vertebral body was measured(M)， on which L/M values was calculated. The C₃～C₆ uncinate process hyperplasia was divided into three types based on shift distance of the vertebral artery. TypeⅠ：the vertebral artery with no shift；Type Ⅱ：shift distance of the vertebral artery less than 2.5 mm；Type Ⅲ：shift distance of the vertebral artery more than 2.5 mm. Results:（1）In the observed 610 uncinate processes, the number of influence on the vertebral artery due to uncinate process hyperplasia was 68，most commonly seen in the 6th cervical vertebra while most rarely seen in the 3rd cervical vertebra. The number of influence on the vertebral artery due to superior articular process hyperplasia was 41，most commonly seen in the 4th and 5th cervical vertebra. Uncinate processes hyperplasia were more likely to influence the vertebral artery than the superior articular processes（c²=12，P<0.01）.（2）In addition to the third cervical vertebra，C₄～C₇ left and right sides of L/M values were not significantly different.（3）The number of typeⅠright uncinate processes hyperplasia of C₃～C₆ was 140 and L/M value was 0.996±0.104； and the number for typeⅡwas13 and L/M value was 1.084±0.080；type Ⅲ was 11 with L/M value of 1.252±0.124. The number of typeⅠdegree of left uncinate processes hyperplasia of C₃～C₆ was 130 and L/M value was 0.980±0.060 while type Ⅱ was 11 withL/M value of 1.044±0.056；type Ⅲ was 15 and L/M value was 1.200±0.060. The numbers of right and left uncinate processes were not significantly different in the three types of hyperplasia. Conclusion：Cervical artery CTA can precisely determine the relationship between vertebral artery and the surrounding bone structures. And uncinate processes are more likely to influence the vertebral artery than the superior articular processes. Calculated L / M values can determine the degree of influence of uncinate processes on the vertebral artery.

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相似文献/References:

备注/Memo

备注/Memo:

 基金项目 天津市卫生局科技基金资助项目（2011KY23）
作者简介 宋明（1988-），男，硕士在读，研究方向：周围血管疾病影像诊断；通信作者：万业达，E-mail: yd_wan@sina.com。

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更新日期/Last Update: 2014-03-31