めまい患者における椎骨脳底動脈系のMRA所見と動脈硬化

Lipoprotein (a) in Patients with Vertebro-Basillar Atherosclerosis and a Comparative Study between Peripheral Vestibular Disorders and Vertebro-Basillar Insufficiency for Vertigo by MRA

　はじめに

　われわれはめまい患者の椎骨脳底動脈系（以下，VA-BA系）の虚血を検討するために，MRAのタイプをI〜IVの4つに分類して報告した^1）。その要旨は，椎骨脳底動脈循環不全症（以下，VBI）を認める症例のMRA像はタイプIII，IVに多く，さらに脳梗塞へ移行するMRA像はタイプIVに多いことである^1）。

　これら4つのタイプのうち，III，IVでは，I，IIに比べてMRA上の血管所見および脳血管撮影所見から動脈硬化が強く疑われるものであった^1）。

The aim of this study was to evaluate the role of lipoprotein (a) in vertebrobasillar atherosclerosis and was to investigate whether MRA findings can distinguish vertebrobasilar insufficiency (VBI) fromperipheral vestibular disorders (PVD) for evaluating the efficiency of MRA in vertigo patients.

A total of 150 vertigo patients were examined by MRA with 3 D-phase contrast method. The total number of VBI patients who showed type III or IV in MRA were significantly higher than that of type I , II (p＜0.005). The total number of high Lp (a) patients who showed type III or IV in MRA were significantly higher than that of type I , II (p＜ 0.01). These data shows that MRA examination and blood test of Lp (a) on vertigo patient is useful not only to help to find etiology but also to predict the stage of atherosclerosis in each patient.