摘要
目的:在椎动脉及相关疾病中比较数字减影血管造影术、计算机控制体层摄影造影术、磁共振血管造影术3种影像学检测方法应用的价值及其差异。资料来源:应用计算机检索Medline1990-01/2004-12期间关于磁共振血管造影术、计算机控制体层摄影造影术或者数字减影血管造影术在椎动脉及相关疾病的应用,检索词:“VA,photography,vertebralartery,Angiography,DSA,CTA,MRA″。同时检索万方数据库1990-01/2004-12期间关于3种影像学检测方法在椎动脉及相关疾病的应用,检索词:“椎动脉,摄影,造影,DSA,CTA,MRA”。限定语言种类为中文。资料选择:对资料进行初审,选择符合要求的有关文献,并查找全文。排除重复性的研究。资料提炼:共收集到有关影像学检测方法在椎动脉及相关疾病的应用的文献47篇,排除重复性研究17篇,纳入30篇。其中有关磁共振血管造影术在椎动脉及相关疾病的应用11篇,有关计算机控制体层摄影造影术在椎动脉及相关疾病的应用6篇,数字减影血管造影术在椎动脉及相关疾病的应用13篇。资料综合:数字减影血管造影术目前是椎动脉测量和相关疾病诊断的“金标准”,近年来以较安全的CO2在数字减影血管造影术中代替碘油充当造影剂。计算机控制体层摄影造影术是随着CT技术的发展新兴的一种检查手段,和数字减影血管造影术同属有创检查。在椎动脉检测中能很好的显示局部受压的部位原因及程度,但不能反映血流速度,血流量和血流方向,甚至可能夸大血管狭窄程度。磁共振血管造影术属于无创检查。对正常椎动脉和椎动脉狭窄的诊断优势及适用性、准确性普遍公认。但对椎动脉夹层动脉瘤的磁共振血管造影术诊断还有着较大的争论和分歧。结论:数字减影血管造影术、计算机控制体层摄影造影术、磁共振血管造影术3种检测方法有着各自的优缺点,无创性敏感性俱佳的磁共振血管造影术检查将在临床椎动脉常规检查扮演越来越重要的角色。
OBJECTIVE： To compare the application value and the differences of the three main photography methods of digital subtraction angiography （DSA）, computerized tomographic angiography （CTA） and magnetic resonance an giography （MRA） in vertebral artery or the related disease. DATA SOURCES： A computer-based online search of Medline database was undertaken to identify articles about the applications of MRA, CTA and DSA in vertebral artery and related diseases published in English from January 1990 to December 2004 by using the keywords of “VA, photography, vertebral artery, angiography, CTA, DSA, MRA”. Chinese articles about the applications of MRA, CTA and DSA in vertebral artery and related diseases published between January 1990 and December 2004 were searched in Wanfang database, the keywords were “vertebral artery, photography, angiography, CTA, DSA, MRA”. STUDY SELECTION： The data were checked firstly, the accordant articles were selected, and then the full-texts were searched, the reproducible ones were excluded. DATA EXTRACTION： Totally 47 articles about the applications of MRA, CTA and DSA in vertebral artery and related diseases were collected, 17 repetitive studies were excluded, and 30 were involved, including 11 about the application of MRA in vertebral artery and related diseases, 6 about the application of CTA in vertebral artery and related diseases, and 13 about the application of DCA in vertebral artery and related diseases. DATA SYNTHESIS： DSA was the “gold standard”at all, although the operation injury and photography drugs poisonousness and by-effect had not been resolved. CO2 was considered to be a safe and hopeful photography drugs without iodine in recent reports. CTA had almost the same defects as DSA. Some articles pointed that CTA was better than DSA or MRA since it could show When,Where, How the local vetibral artery depression had occurred. Some researches reported that CTA would exaggerate the VA depression leavel. MRA was noninvasive. Diagnostic advantage, applicability and accuracy of MRA in the detection of vertbral artery were generally accepted while there were still some dissensions when we work over vertebral artery dissection. CONCLUSION： DSA, CTA and MRA have their own advantages and shortcomings, and the noninvasive MRA with good sensitivity will play a more and more important role in the clinical routine examination of vertebral artery.
出处
《中国临床康复》
CSCD
北大核心
2005年第38期136-139,共4页
Chinese Journal of Clinical Rehabilitation
