Evaluation Of Dual Source CT Angiography (DSCTA) In Diagnosing The Vertebro-Basilar Artery Insufficiency (VBI)'s Etiopathogenisis

Objective:To investigate the diagnostic value of dual source CT angiography(DSCTA) on etiopathogenisis of vertebro-basilar artery insufficiency(VBI) by utilizing DSCTA to display the pathological changes of vertebro-basilar arteries.Method.1.Patients data:86 patients(48 males and 38 females;mean age 63 years,rage 36～81) suspected as vertebro-basilar artery insufficiency(VBI) from January 2008 to December 2008 underwent the DSCTA examination.172 arteria vertebralis and 86 arteria basilaris were researched.32 in 86 patients underwent DSA examination within two weeks.2.Examining technology:The 86 patients were performed DSCTA.Then the original data was transported to the workstation MMWP8818 for restitution post-processing using 2D,3D and Neuro DSA.The post-processing methods including maximum intensity projection(MIP),multiplanar reformation(MPR), volume rendering(VR),curved planar reformation(CPR).And we evaluated the vertebro-basilar arteries by correlated grading rules.Results.1.The results of DSCTA:Of 172 vertebral arteries in 86 patients,56 arteries were found normal.Of 116 arteries,67 arteries were found stenosis,in which 55 arteries were caused by scleratheroma plaque and 10 arteries were caused by cervical vertebrae oppression;39 arteries were found circuity;16 patients were found inborn variation;2 patients were found Takayasu's arteritis;1 patient was found stealing blood from subclavian artery;2 artery were found aneurysm.Some of the arteries combined more than two kinds of pathological changes. 2.The contrast results of DSA:In contrast analysis both DSCTA and DSA were performed in 32 patients,CTA agreed with DSA categorization of a stenosis in 52 of the 64 arteries.When 70%stenosis was used as the cut-off value,the sensitivity,specificity,negative predictive value and the positive predicting valuewere 92.3%,96.1%,98.0%and 85.7%,respectively.When 50%stenosis was used as the cut-off value,the sensitivity,specificity,negative predictive value and the positive predicting value were 91.7%,90.0%,94.7%and 84.6%,respectively.Conclusion:1.DSCTA has special Neuro DSA software and powerful post-processing function,we can get single vascular images easily.Meanwhile,it displays the relationship of vertebral artety and adjoining tissues,especially ceruical uertebra. Recombined images of bones or without bones combined with primitive spoke images,it is accurate and reliable in observing vertebra-basilar artery morphology.2.DSCTA and post-processing technology display the narrow degree and narrow range of vertebral artery veritably,it shows the nature of scleratheroma plaque and the relation with surrounding bones.It is valuable in diagnosing vertebral artery narrowing,especially in distinging vertebral artery narrowing of different agents.3.DSCTA is easy,time-saving,no-found and safe,the result is full-scale and reliable,it is the capital option in diagnosing vertebra-basilar artery insufficiency.