Uchino Akira, Minamimura Kenzo
Department of Radiology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Department of Neurosurgery, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Surg Radiol Anat. 2025 May 19;47(1):139. doi: 10.1007/s00276-025-03652-6.
To describe a case of common origin of the right vertebral artery (VA) and the right costocervical trunk (CCT) diagnosed by magnetic resonance angiography (MRA).
A 74-year-old woman with cerebral infarctions underwent cranial magnetic resonance imaging (MRI) and head and neck MRA using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.
Cranial MRI showed an acute infarction of the posterior limb of the right internal capsule. MRA of the intracranial region revealed no significant pathological lesions. MRA from the aortic arch (AA) to the craniovertebral junction level also showed no pathological lesions; however, there was a common origin of the right VA and CCT. The right VA normally enters the C6 transverse foramen (TF).
Using MRA, we diagnosed a case of a common origin of the right VA and CCT, an extremely rare arterial variation. This type of right VA is considered to result from the same embryonic developmental variation as the left VA arising from the AA distal to the left subclavian artery. Usually, this type of right VA enters the 7th TF, however, the right VA of our patient entered the normal 6th TF. We cannot explain why the right VA of our patient did not enter the 7th TF. The image quality of MRA is not excellent; however, the creation of both partial VR images and reformatted images is useful and important for the identification of rare arterial variations.
描述一例通过磁共振血管造影（MRA）诊断出的右椎动脉（VA）和右肋颈干（CCT）共同起源的病例。
一名患有脑梗死的74岁女性接受了使用3特斯拉扫描仪进行的头颅磁共振成像（MRI）以及头颈部MRA检查。MRA采用标准的三维时间飞跃技术进行。
头颅MRI显示右侧内囊后肢急性梗死。颅内区域的MRA未发现明显的病理性病变。从主动脉弓（AA）到颅颈交界水平的MRA也未显示病理性病变；然而，发现右VA和CCT存在共同起源。正常情况下，右VA进入C6横突孔（TF）。
通过MRA，我们诊断出一例右VA和CCT共同起源的病例，这是一种极其罕见的动脉变异。这种类型的右VA被认为与起源于左锁骨下动脉远端AA的左VA是由相同的胚胎发育变异导致的。通常，这种类型的右VA进入第7个TF，然而，我们患者的右VA进入了正常的第6个TF。我们无法解释为什么我们患者的右VA没有进入第7个TF。MRA的图像质量并不理想；然而，创建部分VR图像和重新格式化图像对于识别罕见的动脉变异是有用且重要的。
