[由第二段脊椎动脉外压缩引起的脊椎底座缺陷]
D V Turliuk1,2, N A Rogovoy1, V Ya Khrischanovich1
1Belarusian State Medical University, Minsk, Republic of Belarus.
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
|December 26, 2023
概括
对于位置性脊椎动脉疾病,导致严重的脊椎底座功能缺陷,建议进行外科手术. 诊断标准包括血流速度降低,脉动率指数降低和SPECT定义的输液缺陷.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 诊断成像 诊断成像 诊断成像
背景情况:
- 脊椎基底区域血流的位置性障碍会导致显著的神经症状.
- 脊椎动脉 (VA) 的V2-V3段受损是这些疾病的常见原因.
- 准确的诊断和手术指示的识别对于有效的治疗至关重要.
研究的目的:
- 建立在脊椎基底区域的位置性血流障碍的手术治疗标准.
- 为了确定脊柱动脉外压缩和脊柱基础缺陷 (VBI) 之间的关系.
- 开发一种诊断算法,用于需要手术纠正的高度VBI.
主要方法:
- 研究了114名患有系统性和非系统性头的患者.
- 利用超声波双重扫描,选择性血管造影,MRI,SPECT和神经心理测试来评估VA和后脑循环.
- 根据VBI的严重程度将患者分为三组.
主要成果:
- 严重的VBI (94.3%) 在V2-V3 VA段显示出extravasal压缩的迹象.
- 在患有严重VBI的患者中观察到S/D比率,RI和PI升高.
- 在42.9%的严重VBI患者中,SPECT揭示了部区域的 perfusion 缺陷 (>20%),与临床症状相关 (r=0.7).
- 开发了一种算法来诊断VBI及其与VA压缩的因果关系,确定了33名患者进行手术.
结论:
- 脊椎基底区域血流失补偿,以>50%的减速,低PI,异常的喘息/影像测试和>20%的SPECT输液缺陷表示,需要进行手术纠正.
- 这些标准有助于识别需要手术干预的位置性脊柱动脉压缩患者.
- 该研究为诊断和管理由于VA压缩导致的VBI提供了一个框架.
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