椎骨動脈系の血流不全によるめまい症状と考えられた症例の椎骨動脈1st segmentにおける, 頸部運動に伴う血管形態と血行動態の変化について

―Color Doppler Flow Imageと3 Dimensional Color Power Angioによる―

抄録

There are multiple factors and disorders causing vertigo and dizziness. Furthermore, it is improved soon under the usual therapies, so enough study of its pathogenecity has not been done and not been able to be done. But some cases (especially so-called cervical vertigo, benign positional vertigo, vertebrobasilar insufficiency etc. ) seem to be related to a low blood flow state of vertebro-basilar arterial circulation. There is objectively almost no adequate method to detect the phenomena at present. At this time we have studied 43 patients without otological diseases who complained of vertigo or have had it before. First we used ultrasonography and examined the blood flow and the form of the first segment of the vertebral artery (VAlst) by Color Doppler flow image (CDFI) and 3 dimensional color power angio (3D-CPA) with the power doppler method. By using these modalities, we have been able to see the vascular specifics and deviations of VAl St that were accompanied by the process of neck rotations from right to left. Pulsatility index (PI) and Resistive index (RI) show vascular perculiarity and vascular blood flow changes. According to statistics in RI, there were differences between the neck position of rotating to the right side (R-rVA) and the neutral position of the right VAlst (N-rVA) (p=0.0105), the neck position of rotating to the right side (R-1VA) and the neck position of rotating to the left of the left VAlst (L-1VA) (p=0.0054) . Furthermore, in the PI, there were differences between R-rVA and N-rVA (p=0.0276), L-rVA and N-rVA (p=0.0130) of the right VAlst, R-1VA and L-1VA (p=0.0130) . So neck rotations have to be exercised greatly as influences on the blood flow mechanism at VAlst. Furthermore, there is a sufficiently similar correlation between CPA and cervical magnetic resonance angiography.