探讨椎-基底动脉夹层动脉瘤（VBDA）的临床与影像学特点。

回顾性分析2008年1月—2014年3月收治的57例VBDA患者的临床表现、DSA检查结果、CT/MRI和CTA/MRA的阳性结果。

57例VBDA患者以蛛网膜下腔出血（SAH）发病28例（49.1%）、以缺血性卒中发病20例（35.1%）、以颈枕部痛发病5例（8.8%)、无症状4例（7%）。最常见的临床症状是头痛（59.6%）、恶心呕吐（54.4%）、头晕（42.1%）、颈枕部痛（26.3%）等。行DSA检查55例，确诊55例；行CTA检查33例，确诊7例；行MRA检查8例，确诊1例；行高分辨MR检查4例，确诊4例。最常见的DSA、CTA、MRA表现是均为串珠征（67.3%）和鼠尾征（25.5%）。最常见的动脉瘤类型是囊状动脉瘤，其他还有梭形动脉瘤及载瘤动脉的异常增粗。

VBDA多以SAH发病，临床症状除SAH外多以后循环缺血或梗死为主，DSA相较于其他影像学检查更为准确，高分辨MR在诊断VBDA方面有巨大潜力。

To evaluate the clinical and imaging characteristics of vertebral-basilar dissection aneurysm (VBDA).

A retrospective review of 57 cases of VBDA patients between Jan 2008 and Mar 2014 in our hospital was performed. The clinical manifestation, the DSA findings, positive CT/MRI and CTA/MRA results was analyzed.

Hemorrhagic stroke was identified in 28 cases (49.1%), ischemic stroke in 20 cases (35.1%), cervical occipital neuralgia in 5 cases (8.8%), asymptomatic in 4 cases (7%). The most common clinical symptoms were headache (59.6%), nausea and vomiting (54.4%), dizziness (42.1%), cervical occipital pain (26.3%). Diagnosis was confirmed by DSA in 55 cases among 55 cases, by CTA in 7 among 33 cases, by MRA in 1 among 8 cases; by high resolution MR in 4 among 4 cases. The most common sign of DSA, CTA and MRA is bead syndrome (67.3%) and rat tail sign (25.5%). The most common type is the saccular aneurysms, with fusiform aneurysm and parent artery abnormal thickening as less common signs.

SAH is the most common onset syndrome of VBDA, while other common clinical signs include post-circulation ischemia or infarction. DSA is the most valuable imaging exam for VBDA, and high resolution MRA is a diagnostic method with great potential.