Objective To investigate the predisposing factors and anatomical basis of patients with posterior circulation ischemia (PCI) in anomalous vertebrobarsilar artery by 128‐slice spiral CT ,angiography (CTA) of cerebral and carotid . Methods A total of 729 patients diagnosed or suspected as PCI were examined by 128‐slice CTA .There were 204 patients (27 .9% ) diagnosed as anomalous vertebrobarsilar artery .We analysed retrospectively the position and quantity of anoma‐lous vertebrobarsilar artery in origin ,path ,caliber and fenestration ,and the correlation of PCI .Results Among of 204 patients with PCI ,merely vertebral artery dysplasia was 50 cases (6 .86% );Merely vertebral artery anomalous path was 37 cases (44 vertebral arteries ,5 .08% );Vertebral artery fenestration was 33 cases (4 .53% );Alone vertebral artery formed basilar artery was 29 cases (3 .98% );Anomalous origin and path anomalies was 28 cases (3 .84% );Anomalous origin and vertebral artery dysplasia was 21 cases (2 .88% );Merely vertebral artery anomalous origin was 5 cases (0.69% );Vertebral artery duplication was 1 case (0 .14% ) .Conclusion Anomalous vertebrobarsilar artery is the one of the important predisposing factors of PCI ,128‐slice CTA examination can display the various development anomalous of vertebral basilar artery and anatomic anomalies quickly ,noninvasively and intuitively ,which provides reliable and impor‐tant radiological and anatomical basis for clinical research in anomalous vertebrobarsilar artery and correlation of PCI .%目的：探讨头颈部128层CT血管成像（CTA）检查诊断椎‐基底动脉发育异常对后循环缺血（posterior circu‐lation ischemia ，PCI）患者发病诱因和解剖基础。方法收集经临床诊断或拟诊为PCI并行128层CTA检查的患者729例，其中头颈部C T A诊断为椎‐基底动脉发育异常的患者204例（占27．9％）。回顾性统计并分析了椎基底动脉在起源、路径、口径、窗式等发育异常的部位及数量与PCI诱因的相关性。结果204例PCI患者中，单纯椎动脉发育不良50例（6．86％）；单纯椎动脉路径异常37例（44根，5．08％）；椎动脉窗式异常33例（4．53％）；单干椎动脉形成基底动脉29例（3．98％）；起源异常合并路径异常28例（3．84％）；起源异常合并椎动脉发育不良21例（2．88％）；单纯椎动脉起源异常5例（0．69％）；椎动脉数目异常1例（0．14％）。结论头颈部128层C T A检查可以简单快速、无创、完整直观的显示椎基底动脉的各种发育和解剖异常。
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