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椎基底动脉的解剖学特征:基于计算机断层血管造影的三维重建研究。

Anatomic characteristics of the vertebrobasilar artery: A three-dimensional reconstruction study based on computed tomography angiography.

作者信息

Chao Qing, Hu YuanLiang, Zhao Biao, Sun YuXi, Shu Hansheng, Wang DaWei, Cheng Zhe

机构信息

Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical University, Bengbu City, Anhui Province, China.

Department of Neurosurgery of Feng yang County People's Hospital, Fengyang City, Anhui Province, China.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41931. doi: 10.1097/MD.0000000000041931.

Abstract

The vertebrobasilar artery (VBA) exhibits substantial inter-individual variation that must be considered in diagnosis and surgical planning. We conducted 3-dimensional reconstruction of the bilateral VBA based on head and neck computed tomography angiography (CTA) to assess bilateral, individual, age-dependent, and sex-dependent differences in anatomical parameters. A retrospective study was performed. Individual 3-dimensional models of the VBA and skull were constructed and morphology evaluated based on head and neck CTA data from 199 adults. According to morphological and anatomical variation, the VBA was divided into 3 types: balanced, L, and S. The diameters and lengths of basilar and bilateral vertebral artery (VA) intracranial segments as well as VBA blending length, and bilateral distances of the vertebral arteries moving up the atlas were measured and statistically compared. The L-type was the most common VBA morphology, and anatomic type distribution differed significantly by age (P < .05). VA diameter was 3.34 ± 0.68 mm on the left side and 3.09 ± 0.71 mm on the right side, while bending length was 5.62 ± 3.35 mm on the left and 4.94 ± 3.41 mm on the right side. Balanced basilar arteries measured 3.41 ± 0.61 mm in diameter, 2.83 ± 0.33 cm in length, and 2.55 ± 2.45 mm in bending length. The L-type basilar artery measured 3.48 ± 0.71 mm in diameter, 3.06 ± 0.44 cm in length, and 2.78 ± 0.37 mm in bending length. Finally, S-type basilar arteries measured 3.84 ± 0.86 mm in diameter, 3.38 ± 0.61 cm in length, and 3.67 ± 4.39 mm in bending length. The distance traveled by the VA across the atlas differed significantly between left and right sides as well as between males and females (P < .05). The vertebrobasilar arteries in the general healthy population were successfully fused and 3-dimensionally reconstructed based on the CTA, and an observational study was conducted on their morphological and anatomical characteristics. Three-dimensional reconstruction of the VBA using CTA is feasible for anatomical research and also has diagnostic value for the variations and anatomical parameters of the VBA.

摘要

椎动脉(VBA)存在显著的个体差异,在诊断和手术规划中必须予以考虑。我们基于头颈部计算机断层扫描血管造影(CTA)对双侧VBA进行三维重建,以评估解剖参数的双侧、个体、年龄依赖性和性别依赖性差异。进行了一项回顾性研究。根据199名成年人的头颈部CTA数据构建了VBA和颅骨的个体三维模型,并对形态进行了评估。根据形态和解剖变异,将VBA分为3种类型:平衡型、L型和S型。测量并统计比较了基底动脉和双侧椎动脉(VA)颅内段的直径和长度、VBA融合长度以及椎动脉向上穿过寰椎的双侧距离。L型是最常见的VBA形态,解剖类型分布在不同年龄组间差异有统计学意义(P < 0.05)。左侧VA直径为3.34 ± 0.68 mm,右侧为3.09 ± 0.71 mm;左侧弯曲长度为5.62 ± 3.35 mm,右侧为4.94 ± 3.41 mm。平衡型基底动脉直径为3.41 ± 0.61 mm,长度为2.83 ± 0.33 cm,弯曲长度为2.55 ± 2.45 mm。L型基底动脉直径为3.48 ± 0.71 mm,长度为3.06 ± 0.44 cm,弯曲长度为2.78 ± 0.37 mm。最后,S型基底动脉直径为3.84 ± 0.86 mm,长度为3.38 ± 0.61 cm,弯曲长度为3.67 ± 4.39 mm。VA穿过寰椎的距离在左右侧以及男女之间差异有统计学意义(P < 0.05)。基于CTA成功对一般健康人群的椎动脉进行了融合和三维重建,并对其形态和解剖特征进行了观察性研究。利用CTA对VBA进行三维重建用于解剖学研究是可行的,对VBA的变异和解剖参数也具有诊断价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ad8/11936587/9fb8d4bbd9ea/medi-104-e41931-g001.jpg

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