MSCT诊断脑动脉正常变异课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,MSCT,诊断脑动脉正常变异,MSCT诊断脑动脉正常变异,提 要,脑动脉的正常解剖及分段,脑动脉的正常变异,提 要脑动脉的正常解剖及分段,脑动脉系统,颈内动脉和椎,-,基底动脉,特点：,脑底部形成动脉环：,其构成或变异直接影响各脑,动脉的形态、管径及代偿潜能,脑动脉管壁薄,脑动脉行程均较弯曲,脑动脉系统颈内动脉和椎-基底动脉,一、脑动脉分段,一、脑动脉分段,颈内动脉颅内段,颈内动脉颅内段,颈内动脉颅内段,C5,：岩骨段（颈动脉管段）,C4,：海绵窦段,C3,：膝段,-,发出眼动脉,C2,：床突上段,C1,：终段,-,后交通动脉,脉络前动脉,ACA,MCA,虹吸段,颈内动脉颅内段C5：岩骨段（颈动脉管段）虹吸段,ACA,A1,：,水平段,(,交通前段,),A2,：,上行段,(,胼胝体下段,),A3,：膝段,A4,：胼周段,A5,：终段,楔前动脉,A2,A3,A4,A5,ACAA1：水平段(交通前段)A2A3A4A5,MCA,M1,：水平段（眶后段）,M2,：岛叶段（回转段）,-,颞前动脉,M3,：岛盖段（外侧沟段）,-,升动脉,M4,：分叉段,-,顶后动脉、颞后动脉,M5,：终末段,-,角回动脉,MCAM1：水平段（眶后段）,PCA,P1,：交通前段（水平段）,P2,：环池段,P3,：四叠体段,P4,：距裂段,PCAP1：交通前段（水平段）,二、脑动脉变异,二、脑动脉变异,（一）窗式和重复,（一）窗式和重复,ACA,A1,窗式,MRA,ACAA1窗式MRA,MCA,M1,窗式,重复,MCAM1窗式重复,窗式,BA,VA,PCA,窗式BAVAPCA,部分重复与完全重复,合并：原始型（胎儿型）,PCoA,部分重复与完全重复合并：原始型（胎儿型）PCoA,（二）,ACA,的正常变异,单支,ACA,（,Azygos Anterior Cerebral Artery,）,三倍体,ACA,（,Anterior Cerebral Artery Trifurcation,）,A1,缺如或发育不良,（,A1 Segment Absence or Hypoplasia,）,双半球,ACA,（,Bihemispheric Anterior Cerebral Artery,）,ACoA,缺如,（,Absent Anterior Communicating Artery,）,（二）ACA的正常变异单支ACA,MSCT诊断脑动脉正常变异课件,（三）,ACoA,的正常变异,I,、有,ACoA,IA,：左右,A1,段等大,IB,：左右,A1,段不等大,II,、无,ACoA,IIA,：左右,A1,段等大，内侧壁直接吻合,IIB,：左右,A1,段不等大，直接吻合,IIC,：左右,A1,段等大，无直接吻,IID,：一侧,A1,缺如，,A2,段由对侧发出,（三）ACoA 的正常变异I、有ACoAII、无ACoA,副大脑中动脉,（,Accessory middle cerebral artery,）,重复大脑中动脉,（,Duplicated middle cerebral artery,）,大脑中动脉分叉早,（,Early bifurcation of the middle cerebral artery,）,（四）,MCA,的正常变异,副大脑中动脉（四）MCA 的正常变异,副大脑中动脉：细小分支起自,ACA,供应额叶的前下部,易发生动脉瘤,重复大脑中动脉：细小分支起自,ICA,供应颞叶前部,大脑中动脉分叉早（,R,）,1.5cm,与动脉瘤形成无关,大脑中动脉颞前支（,L,）,鉴诊：副大脑中动脉,重复大脑中动脉,副大脑中动脉：细小分支起自ACA重复大脑中动脉：细小分支起自,（五）,Willis,环的类型,（五）Willis环的类型,Willis,环的类型,闭锁性,开放型,现代型,原始型,过渡型,混合型,发育不全型,Willis环的类型闭锁性现代型原始型过渡型混合型发育不全型,原始型（胎儿型,),：完全型：,P1,缺如,部分型：,P1,发育不良,漏斗型（,Infundibulum,）,（六）,PCoA,的正常变异,单侧,双侧,原始型（胎儿型)：完全型：P1缺如（六）PCoA的正常变异,双侧胎儿型,(,原始型,),P1,发育不良,-,部分型,单侧原始型,双侧胎儿型,(,原始型,),P1,缺如,-,完全型,PCoA,的正常变异,双侧胎儿型(原始型)单侧原始型双侧胎儿型(原始型)PCoA的,漏斗型,（,Infundibulum,）,漏斗型（Infundibulum）,（七）增生性脉络膜前动脉,Hyperplastic Anterior Choroidal Artery,（七）增生性脉络膜前动脉 Hyperplastic Ant,（八）,PCA,的正常变异,P1,发育不良,P1,缺如,P1,与小脑上动脉共干,（八）PCA的正常变异P1发育不良,（九）,ICA,变异,C5,段发育不良,鼓室内,ICA,咽旁,ICA,ICA,缺无,（九）ICA变异C5段发育不良,ICA,发育不良,DDX,：,获得性,ICA,阻塞,ICA发育不良,ICA,变异,先天性,ICA,一侧缺无，该侧的血液供应来源可有以下可能,:,由对侧,ICA,经,ACoA,供应,由同侧,BA,经,PcoA,流入,MCA,、,ACA,等分支中,由,ECA,的分支上颌动脉经圆孔或卵圆孔入颅内,ICA变异先天性ICA一侧缺无，该侧的血液供应来源可有以下可,鼓室内,ICA,鼓室内ICA,咽旁,ICA,咽旁ICA,（十）永存颈内动脉,-,基底动脉吻合,永存三叉动脉：,ICA-BA,间最常见的吻合动脉,变异永存三叉动脉：,起自,ICA,近段（海绵窦前段），不与,BA,连接，分,布于,AICA,、,PICA,或,SCA,，常不合并,BA,发育不全,永存舌下动脉,：,起源颈内动脉颅外段,C1-C3,水平,通过舌下神经管，并吻合,BA,BA,只在永存舌下动脉远端充盈,PCoA,缺如,（十）永存颈内动脉-基底动脉吻合永存三叉动脉：ICA-B,永存三叉动脉,永存三叉动脉,变异永存三叉动脉：,起自颈内动脉近端，供应小脑前下动脉区域,变异永存三叉动脉：,永存舌下动脉,永存舌下动脉,MSCT诊断脑动脉正常变异课件,MSCT诊断脑动脉正常变异课件,MSCT诊断脑动脉正常变异课件,MSCT诊断脑动脉正常变异课件,MSCT诊断脑动脉正常变异课件,MSCT诊断脑动脉正常变异课件,MSCT诊断脑动脉正常变异课件,小 结,要认识，不要视而不见，或是误诊,变异的存在，常引起继发疾病，应引起警惕,小 结,THANKS!,THANKS!,