Abstract:Objective To explore the complexity and clinical significance of CTA manifestations of vertebral artery variation.Methods The information of 200 cases of head and neck CTA images completed in Department of Image,Yantai Yeda Hospital from January 2013 to August 2013 was retrospectively analyzed. the anatomical variations of the vertebral artery lumen symmetry, origin, course, number, and abnormal anastomosis were observed. The diversity and complexity of the vertebral artery variation were statistical analyzed.Results In 200 cases, 102 cases had no obvious anatomical variations, 98 cases(49.0%, 98/200) had at least one variation, the most common was small lumen development in 72 arteries of 69 cases (34.5%, 69/200), followed by 28 cases (14.0%, 28/200) of the artery exist different segment of course variations. There were multiple composite variations 19 cases (9.5%, 19/200), and 6 cases (3.0%, 6/200) of the 19 cases had more than 3 kinds of variations. The most common form of multiple composite variations was various kinds of course variation combined with other position and type of variation (7.5%, 15/200).Conclusions CTA has obvious advantages in showing the relationship between vertebral artery and the vertebrae, determining the vertebral artery course variation, and improving the understanding of the complexity of vertebral artery variation and its multiple levels and diagnostic techniques. It may have important significance in the clinical analysis of posterior circulation ischemia, surgical and interventional surgery to avoid vascular injury.
Wakao N, Takeuchi M, Kamiya M, et al. Variance of cervical vertebral artery measured by CT angiography and its influence on C7 pedicle anatomy[J]. Spine(Phila Pa 1976), 2014, 39(3): 228-232.
[5]
Uchino A, Saito N, Takahashi M, et al. Variations in the origin of the vertebral artery and its level of entry into the transverse foramen diagnosed by CT angiography[J]. Neuroradiology, 2013, 55(5): 585-594.
[6]
Hong JT, Park DK, Lee MJ, et al. Anatomical variations of the vertebral artery segment in the lower cervical spine: analysis by three-dimensional computed tomography angiography[J]. Spine(Phila Pa 1976), 2008, 33(22): 2422-2426.
[7]
Rameshbabu C, Gupta OP, Gupta KK, et al. Bilateral asymmetrical duplicated origin of vertebral arteries: multidetector row CT angiographic study[J]. Indian J Radiol Imaging, 2014, 24(1): 61-65.
[8]
Duan S, Lv S, Ye F, et al. Imaging anatomy and variation of vertebral artery and bone structure at craniocervical junction[J]. Eur Spine J, 2009, 18(8): 1102-1108.
Vikram N, Patil MB, Basavaraj B, et al. Anatomical variation of the origin of left vertebral artery a case report[J]. Int J Cur Res Rov(Healthcare), 2013, 5(11): 133-136.
[13]
Gitkind AI, Olson TR, Downie SA. Vertebral artery anatomical variations as they relate to cervical transforaminal epidural steroid injections[J]. Pain Med, 2014, 15(7): 1109-1114.