【2017年整理】椎管内占位MRI诊断.ppt

椎基底动脉扩张延长症 VBD Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 病因 各种原因导致的椎-基底动脉管腔显著增粗并延长移位，病因未明。 总体发生率0.05-4.5%。 先天性异常（结节性硬化、Marfan综合征、Fabry病、镰状细胞病、弹性假黄瘤、常染色体遗传的多囊肾等）、男性、肥胖、高血压、糖尿病、外伤和吸烟可能为其危险因素。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 病理基础 血管壁： 内弹力膜广泛缺陷，中膜网状纤维缺乏，导致动脉管壁在长期血流冲击下发生扩张迂曲，高血压能加速这一过程。 动脉扩张，血流速减慢以及畸形血管内血流动力学都可促进血栓形成、血栓附壁和脱落等继发性管壁损伤，进一步使管壁失去原有的支撑力，加剧扩张和延长。 VBD可能是动脉壁的缺陷、高血压、动脉粥样硬化等多重因素的综合结果。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 基底动脉正常标准 在桥脑腹侧至鞍上池上方 直径约4.5mm 检查方法:CT、MRI、DSA Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. VBD诊断标准:CT 按长度分4级(以鞍背,鞍上池和第三脑室划分) 0级:基底动脉分叉低于或平鞍背水平 1级:低于或平鞍上池 2级:鞍上池和第三脑室之间 3级:达到或高于第三脑室 按偏移度分4级(以鞍背和斜坡正中、旁正中、边缘和边缘以外划分) 0级:位于鞍背和斜坡正中 1级:位于旁正中之间 2级:位于旁正中和边缘之间 3级:位于边缘以外或桥小脑脚 VBD标准：高度≥2级，偏移度≥ 2级，直径≥ 4.5mm Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 诊断标准:MRA Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 大体表现：管径增粗和各种不同的位移 延迟显影：血流减慢和造影剂滞留在脑实质期排除缓慢 诊断标准:DSA Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Cop