Maeder P, Meuli R, Gudinchet F, Bogousslavsky J
Département de radiologie, CHUV, Lausanne.
Praxis (Bern 1994). 1996 Feb 27;85(9):272-7.
This study evaluates the use of MR angiography in the diagnosis of vertebrobasilar stroke. The MRI/MR angiography and clinical presentation of 50 unselected adult patients who presented with ischemic symptoms in the vertebrobasilar territory (10 TIAs, 40 strokes) were prospectively evaluated. Conventional T1 and T2-spin echo sequences were obtained for evaluation of the brain parenchyma, with gadolinium injection in 41 cases and 3D time-of-flight MR angiography in all patients. Data were reconstructed with a maximal intensity projection algorithm and displayed in 3D. Arterial and parenchymal lesions and clinical data were correlated. MR angiography showed intracranial vertebrobasilar lesions in 30 patients (5 stenosis or occlusion of a vertebral artery, 17 stenosis or occlusion of the basilar artery, 6 stenosis of arterial branches of the basilar artery, 10 dolichoectasia of the basilar artery). 7 patients had multiple lesions. Recognized etiologies of the strokes were: 23 vertebrobasilar lesions, 16 nonvertebrobasilar causes, 6 mixed (vertebrobasilar and associated alternative causes) cases, while 5 cases had no recognized cause of stroke. Our study demonstrates a high incidence of intracranial arterial lesions in patients suffering from vertebrobasilar stroke and suggests that MRA can help in a noninvasive way to determine the origin of vertebrobasilar strokes.
本研究评估磁共振血管造影在椎基底动脉卒中诊断中的应用。对50例未经过筛选、出现椎基底动脉供血区缺血症状的成年患者（10例短暂性脑缺血发作，40例卒中）的MRI/磁共振血管造影及临床表现进行了前瞻性评估。获取常规T1和T2自旋回波序列以评估脑实质，41例患者注射钆对比剂，所有患者均行三维时间飞跃磁共振血管造影。数据采用最大强度投影算法重建并以三维形式显示。将动脉和实质病变与临床数据进行关联分析。磁共振血管造影显示30例患者存在颅内椎基底动脉病变（5例椎动脉狭窄或闭塞，17例基底动脉狭窄或闭塞，6例基底动脉分支狭窄，10例基底动脉迂曲扩张）。7例患者有多处病变。已确认的卒中病因包括：23例椎基底动脉病变，16例非椎基底动脉病因，6例混合性（椎基底动脉及相关其他病因）病例，另有5例卒中病因不明。我们的研究表明，椎基底动脉卒中患者颅内动脉病变的发生率较高，并提示磁共振血管造影能够以非侵入性方式帮助确定椎基底动脉卒中的病因。
