Evaluating the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo
Evaluating the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo
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评估未确定的孤立性眩晕中颅内动脉和全脑灌注的形态变化
DOI：
10.1016/j.jns.2016.09.024
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发表时间：
2016-11-15
影响因子：
4.4
通讯作者：
Huang, Li'an
中科院分区：
文献类型：
--
作者：
Li, Wenxian;Feng, Youzhen;Huang, Li'an
目的：应用320排CT （computed tomography， CT）观察未确定孤立性眩晕（UIV）患者颅内动脉形态学变化及全脑灌注。方法：将150例行CT血管造影（CTA）和CT灌注成像（CTP）的患者分为UIV组和良性阵发性体位性眩晕（BPPV）组。60名性别和年龄相匹配的无眩晕和脑疾病的个体作为对照组。分析、计算并比较颅内动脉形态学变化、血流灌注参数及血管危险因素（vrf）。结果：UN患者高血压（HT）、高脂血症、vrf3数发生率较高（P < 0.0125）。椎动脉优势（VAD）、椎动脉狭窄（VAS）和基底动脉弯曲（BAC）发生率均显著高于对照组（P < 0.0125）。HT是非vad的独立危险预测因子（OR: 5.411, 95%a: 1.401; 20.900, P = 0.014）。与BAC相关的HT和VAD作为风险预测因子（OR: 4.081, 95%a 1.056;15.775, P = 0.041; OR: 6.284, 95%a 1.848; 21365, P = 0.003）。小脑和脑干CTP参数相对值的绝对差异有统计学意义（P < 0.05），非vad侧和BAC队列存在灌注不足（P < 0.05）。结论：在多发vrf的基础上，椎基底动脉（VBA）形态学改变及单侧小脑、脑干灌注不足是IV发生的先声，UN患者应谨慎注意。(C) 2016年作者。这是一篇基于CC by-nc-nd许可（http://creativecommons.org/licenses/by-nc-nd/4.0/）的开放获取文章。
Purpose: To determine the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo (UIV) patients using 320-detector row computed tomography (CT).Methods: A total of 150 patients who underwent CT angiography (CTA) and CT perfusion (CTP) imaging were divided into UIV group and benign paroxysmal positional vertigo (BPPV) group. Sixty individuals with sex- and age-matched without vertigo and cerebral diseases served as the control. The morphological changes of intracranial arteries, perfusion parameters and vascular risk factors (VRFs) were analyzed, calculated and compared.Results: In UN patients, hypertension (HT), hyperlipidemia and number of VRFs 3 occurred more commonly (P < 0.0125, respectively). The incidence of vertebral artery dominance (VAD), vertebral artery stenosis (VAS) and basilar artery curvature (BAC) were significantly higher (P < 0.0125, respectively). HT was an independent risk predictor of non-VAD (OR: 5.411, 95%a 1.401; 20.900, P = 0.014). HT and VAD associated with BAC served as risk predictors (OR: 4.081, 95%a 1.056;15.775, P = 0.041 and OR: 6.284, 95%a 1.848; 21365, P = 0.003, respectively). The absolute difference in relative values of CTP parameters from cerebellum and brainstem were significantly different (P < 0.05), and hypoperfusion was found in the territories of the non-VAD side and the BAC cohort (P < 0.05, respectively).Conclusions: On the basis of multiple VRFs, morphological changes of vertebrobasilar artery (VBA) and the unilateral hypoperfusion of the cerebellum and brainstem, that acts as a herald for IV occurrence, which should be paid cautious attention to UN patients. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).