Imaging Research Of The Brain Blood Supply Conditions Of Patients With Cervical Vertigo

Objective:To analyze imaging characteristics of cervical vertigo, and to evaluate the application value of Color Doppler ultrasonography (CDUS), CT angiography (CTA) combined with CT perfusion (CTP), MR angiography (MRA) combined with perfusion weighted imaging (PWI) and proton Magnetic Resonance Spectroscopy (1H-MRS) in patients with cervical vertigo. To evaluate the brain blood supply conditions in cervical vertigo patients, and to provide objective basis for clinical diagnosis and treatment.Materials and Methods:62patients with cervical vertigo diagnosed clinically were enrolled. Neck CDUS, neck CTA and cerebral CTP were performed on39patients. Neck CDUS, cerebral TOF MRA, neck CE-MRA and cerebral PWI were performed on23patients (1H-MRS were performed on20patients of the23patients).Neck CDUS and CTA/MRA were performed on30patients without vertigo symptoms, which were chosen as control group. Evaluate the hemodynamics and morphology between the two groups, and analyze CTP, PWI,1H-MRS imaging findings of cervical vertigo patients. SPSS17.0software package was used for statistical analysis, significant level a=0.05, there was statistics differences when P<0.05.Results:The vertebral artery morphology results which detected respectively by CDUS and CTA/MRA in vertigo group showed no statistical difference (P>0.05).①In aspect of morphology:The incidence of Vertebral artery (VA) stenosis (46.77%,29/62) and VA dysplasia (29.03%,18/62) in cervical vertigo group were higher than VA stenosis (23.33%,7/30) and VA dysplasia (6.67%,2/30) in control group, there were significant difference (all P<0.05). The incidence of tortuous VA showed no statistics difference between cervical vertigo group (11.29%,7/62) and control group (13.33%,4/30)(P>0.05). Vascular stenosis degree between the two groups showed statistics difference (P<0.001), the incidence of moderate and severe VA stenosis (75.86%,22/29) in cervical vertigo group was higher than that in control group (28.57%,2/7). The incidence of PCOA Ⅲ type (45.16%,28/62) in cervical vertigo group was higher than that in control group (20.00%,6/30), there was statistically significant difference (x2=5.494, P=0.019). The incidence of PCOA I type in cervical vertigo group (25.81%,16/62) was lesser than that in control group (56.67%,17/30), there was statistically significant difference (x2=8.370, P=0.004). The incidence of PCOA Ⅱ、Ⅳ、Ⅴ type showed no statistics difference between the two groups(P>0.05).②In aspect of hemodynamics:The decline incidence of peak systolic velocity which detected by CDUS in cervical vertigo group (66.13%,41/62) was higher than that in control group (10.00%,3/30), there was statistically significant difference (x2=25.526, P<0.001). The peak systolic velocity decline incidence of VA stenosis (86.21%,25/29) and VA dysplasia (72.22%,13/18) were higher than that of VA tortuous (28.57%,2/7) and VA normal (12.50%,1/8) patients in cervical vertigo group. CTP and PWI imaging had nothing abnormal been detected in cervical vertigo group, the perfusion parameters showed no statistically difference between both sides of cerebellar hemispheres (all P>0.05).③In aspect of brain metabolism:All observed metabolic values of1H-MRS between both sides of cerebellar hemispheres in cervical vertigo patients showed no statistics difference (all P>0.05).Conclusions:The application of CDUS, CTA combined with CTP, CE-MRA combined with PWI and1H-MRS techniques can provide valuable diagnostic and therapeutic informations for cervical vertigo in the aspects of change in vascular morphology, cerebral hemodynamics and brain metabolism, from which we may objective evaluation of brain blood supply conditions and have comprehensive evaluation of cervical vertigo etiology.