Study On Etiology And Diagnosis In Vascular Vertigo With MRI

Objective: To finding the etiologic factors and obtaining a fairly definite imaging diagnosis conclusion possibly of vascular vertigo by 3.0 T MRI, and directing the clinical treatment for a certain purpose.Methods: Study the 99 patients'imageology data that were diagnosed as vascular vertigo. The standard to be selected:①the vertigo is first clinical situation; may accompanies nausea and vomiting, tinnitus, deafness, nystagmus, dysarthria, right sided facial weakness, dysesthesia, gait disturbance and so on.②Magnetic Resonance shows the vertebral-basilar artery artherosclerosis and posterior circulation ischemic (PCI).③We exclude the meniere disease, labyrinthitis, positional vertigo, otosclerosis, tumor, injury vertigo and so on when we study the cases. All the patients were examined by MRI and MRA. 13 patients were examined by 3D fast imaging employing steady-state acquisition. 32 patients were examined by CT before the inspection of MRI and MRA. The MRI and MRA images were observed by Signa Excite HD 3.0T high field MR scanner. Magnetic Resonance Angiography (MRA) was performed by using a 3D-TOF sequence. With MIP reorganized images assisted by source images. 3D-FIESTA is a special sequence in transverse plane and oblique anteroposterior plane, and 3D reconstruction for some special patients. We adopt GE Light Speed 4 layer or 16layer MSCT scanner. To integrate the case history, clinical situation, physical sign, reference cause of a disease, aggregate analysis the result of MRI,MRA and CT. Images were reviewed concurrently by two skilled radiologists with double blind test. TO grouping the appearance of the brain, the course of vertebro-basilar artery, the relationship of the age and cause of the disease, the abnormity of anterior inferior cerebellar arteryz(AICA) and posterior inferior cerebellar artery(PICA) were observed and recorded. To compare the difference of results of MRI and CT. We strive to achieve a uniform interpretation for clinical situation and imageology appearance. We explore the diagnostic criteria of vascular vertigo by observing the Magnetic Resonance appearance on the brain essence and vascular. Statistical testing was performed by usingχ2 contingency tables and there was significant difference when P<0.05.Results:In the 99 patients, cerebral infarction was 22 cases, brain stem infarction was 3 cases, cerebral and brain stem infarction was 10 cases, brain stem compression was 14 cases,posterior circulation angioma and compress the brain stem 1case.When it comes to brain stem compression, there was no difference between the different sex(χ2=0.499,P=0.480). There was no difference between the right and left vertebral artery about the pathological changes type(χ2=1.080, P=0.998). The difference cause of vascular vertigo consist in different age group case(χ2=19.943,P=0.030). Over the age of 50 in patients with vascular vertigo was 81%. The MRA shows the AICA of the three age group consist in no difference(χ2=5.516,P=0.238), but the AICA of right and left was no difference(χ2=0.296,P=0.862). The MRA shows the PICA of the three age group was no difference(χ2=4.132,P=0.388), but the PICA of right and left was no difference(χ2=0.153,P=0.926). In the 3 cases 6 ears examined by 3D-FIESTA, dysaemias 3 cases. Labyrinthine artery oppressing and/or adhereing vestibulococholear nerve 1 case. There was significant difference between the results of CT and MRI(χ2=14.076,P=0.000). 11 cases with cerebral infarction were made the CT and MRI inspection in the 24 hours and the results of CT and MRI consists significant difference(χ2=12.034,P=0.001).Conclusions: MRI to show the cerebral infarction earlier than CT. MRA to show the blood vessel atherosclerotic macroscopic, to prove the brainstem Compression. 3D-FIESTA shows blood vessel microcosmic, it shows the labyrinthine artery and Vestibular cochlear nerve vascular compression limpidly. Vascular vertigo is common disease, and to have multiformity. Posterior circulation ischemic (PCI) is the main cause of vascular vertigo. brain stem compression, vestibular cochlear nerve vascular compression syndrome,labyrinthine artery syndrome should belong to the vascular vertigo. 3.0T MRI and MRA could provide detailed anatomy information, to provide a basis for diagnosis and treatment of vascular vertigo. 3D-FIESTA-C scanning could to show the relationship of blood vessel and nerve. Comprehensive use of MRI scan, MRA, and 3D-FIESTA sequence, could hunt the cause of vascular vertigo perfectly. This study indicates a way for the study of vascular vertigo.