Ohuchi Shingo, Kawazoe Kohei, Izumoto Hiroshi, Yoshioka Kunihiro
Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, 1-2-1 Chuohdori, Morioka, 020-8505, Japan.
Surg Today. 2005;35(6):432-5. doi: 10.1007/s00595-004-2973-4.
To evaluate the incidence of vascular lesions in the head and neck by magnetic resonance angiography (MRA), and investigate the factors correlated with severe stenosis.
Elective coronary artery bypass grafting (CABG) was performed in 413 patients at our center between May 1997 and April 2001. We used MRA to detect head and neck vascular lesions, then evaluated the occlusive lesions and determined their prevalence.
Neck MRA was performed in 335 patients and head MRA was performed in 335 patients. We found > or = 60% stenosis or total occlusion of the extracranial carotid and vertebral artery in 43 patients (12.8%) and > or = 60% stenosis or occlusion of the intracranial carotid and basilar artery, or stenosis accompanied by poor peripheral perfusion or occlusion of the cerebral arteries in 45 patients (13.4%). Occlusive lesions of the neck were significantly correlated with mean age, peripheral vascular disease (PVD), and old myocardial infarction. Occlusive lesions of the brain were significantly correlated with age, hypertension, PVD, and left main trunk disease.
We found an equal incidence of intracranial and extracranial vascular lesions. Thus, searching for intracranial lesions is just as important as searching for extracranial lesions before CABG.
通过磁共振血管造影（MRA）评估头颈部血管病变的发生率，并研究与严重狭窄相关的因素。
1997年5月至2001年4月期间，我们中心对413例患者进行了择期冠状动脉旁路移植术（CABG）。我们使用MRA检测头颈部血管病变，然后评估闭塞性病变并确定其患病率。
335例患者进行了颈部MRA，335例患者进行了头部MRA。我们发现43例患者（12.8%）的颅外颈动脉和椎动脉存在≥60%的狭窄或完全闭塞，45例患者（13.4%）的颅内颈动脉和基底动脉存在≥60%的狭窄或闭塞，或狭窄伴有周围灌注不良或脑动脉闭塞。颈部闭塞性病变与平均年龄、外周血管疾病（PVD）和陈旧性心肌梗死显著相关。脑部闭塞性病变与年龄、高血压、PVD和左主干疾病显著相关。
我们发现颅内和颅外血管病变的发生率相同。因此，在冠状动脉旁路移植术之前，寻找颅内病变与寻找颅外病变同样重要。
