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Background: the vertebrobasilar extended ectasia (vertebrobasilar dolichoectasia, VBD) is a rare unexplained after abnormal vascular diseases. Diverse, atypical clinical manifestations of the disease, and the majority of patients is not associated with significant clinical symptoms, easily lead to missed diagnosis and misdiagnosis of both doctors and patients neglect. VBD diagnostic criteria by Smoker equal, established in 1986, but its methods of measurement of the diameter of the vertebral - basilar artery (vertebrobasilar artery, VBA) applications handheld eyepiece measuring indirect measurement of the target artery diameter in the CT images on film, subjective bias. MRI has become important examination method for the diagnosis and screening of intracranial lesions, but the domestic MRI screening standards for adult VBD research has not been reported. Therefore, this study for the first time by direct measurement of the original screen image of a normal adult MRI on VBA diameter, the preliminary set VBD MRI screening standard, and to explore different forms of symptomatic VBD risk factors and VBA with corresponding clinical manifestations designed to provide reference for the VBD clinical diagnosis and early prevention. Methods: The study is divided into two parts. Part 1, selected from March 2010 to March 2011 at the First Hospital of Jilin University, admitted to hospital, clinic patients and healthy individuals. Each into objects simultaneously head MRI and MRA, MR original image will get medical digital image transfer (DICOM) standard transmission to PACS database, computer screen image display ratio is raised to 400% unified application of the mouse on the screen image direct point check mark and distance measurement obtained the value of the target artery diameter, numerical precision to 0.1mm. Measuring a total of 11 arteries: the middle of the basilar artery pons, bilateral vertebral arterial V4 segment, bilateral posterior cerebral artery P1 segment, the C4 segment internal carotid artery, bilateral middle cerebral artery M1 segment, bilateral anterior cerebral artery A1 segment. The statistical analysis of, and to set VBA expansion MRI screening standards. Part 2, according to the results of Part 1, screening suspected VBD patients and selected age sex matched healthy subjects, compare the general information collection and analysis, caused by atherosclerosis risk factors, imaging and clinical features. Results: ① The VBD MRI screening standards: VBA expansion: BA in approximate diameter male ≥ 4.2mm the women ≥ 4.1mm; the LVA males ≥ 3.8mm the women ≥ 3.5mm; the RVA men ≥ 3.6mm ≥ 3.2mm female. VBA to extend and the tortuosity: VA confluence of the cross to the contralateral side of the VA to ride above the pons and the medulla oblongata ditch and, the BA bifurcation height or sway the degree grading ≥ 2 levels. ② VBD group clinical manifestations: circulation infarction after 52 patients (40.4%), more than 10 cases (19.2%) particularly in the the PCA blood supply to the area of ??cerebral infarction. 18 patients (34.6%) associated with cranial nerves and brain stem compression irritation, dizziness most common in 15 cases (83.3%), then tinnitus, hemifacial spasm and peripheral facial paralysis, choking water, trigeminal neuralgia, nystagmus or eyeball movement disorders. The ③ VBD group of asymptomatic patients (23 patients, 44%) see a lot of. Symptomatic group in the, VBA diameter the average, hypertension incidence with 2 AS caused more risk factors, with a the stem compression levy and VA riding cross-levy ratio than in the asymptomatic group increased, there is a significant difference. ④ tortuosity group simply extend the simple expansion group and extend tortuous expansion group, clinical manifestations was no significant difference among groups divided based on VBA form. Conclusion: ① MRI screen image in VBA diameters measured values ??can be used as the standard MRI screening VBD. ② VBA diameter size, brain stem compression levy, VA straddling levy, history of hypertension, and has two or more risk factors caused by AS VBD risk factors associated with the clinical symptoms. The different morphological ③ VBA VBD clinical manifestations specific related.
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