目的　观察椎动脉型颈椎病患者的影像学表现，探讨其发病机制。　方法　本组60例椎动脉颈椎病患者，年龄（35~68）岁，平均52岁,病史为4个月，最长为2年,均有2次以上间歇性眩晕发作。所有患者均接受系统的影像学检查，包括颈椎正侧位及动力位X线摄片、颈椎MRI、颈椎MRA及经颅多普勒超声（TCD)检查等。　结果　60例中，X线检查表现正常3例，颈椎曲度变直10例，退行性改变44例，不稳3例；MRI提示颈椎退行性变42例，明显椎间盘突出或黄韧带皱褶导致硬脊膜受压18例； MRA检查表明椎动脉管径及走行正常者38例，单侧椎动脉纤细10例，椎动脉扭曲12例，未见椎动脉闭塞。　TCD检查提示椎基底动脉血流速度正常者8例，其余均存在明显改变。　结论　颈椎退行性改变引起局部颈椎失稳及炎症反应，刺激交感神经，诱发椎动脉收缩及痉挛，导致椎基底动脉供血不足是椎动脉型颈椎病的主要发病机制。

Objective　 To explore imaging features and pathomechanism of cervical spondylotic vertebral artery insufficiency.　Methods　Sixty cases with cervical spondylotic vertebral artery insufficiency were included in this study, with the average age of 52(from 35 to 68), the average medical record of 4 months (the longest of 2 years), and the 2 times' of intermittent vertigo at least. Systematic imaging examinations were carried out for every case, including cervical anteroposterior, lateral and dynamic X-ray films, MRI, MRA and transcranial doppler (TCD) scan.　Results　X-ray films showed the healthy cases(3), the cases of straightforward changes of cervical curve(10) , the cases of degenerative changes(44), and the cases of cervical instability(3) respectively. However, MRI showed degenerative changes in 42 cases, and the compression of cervical dura resulting from cervical intervertebral disc hernia or the fold of ligamentum flavum in 18 cases. MRA examinations showed the normal ones in 38 cases, the slim change of unilateral vertebral artery in 10 and  the tortuosity in 12 cases，without obvious vertebral artery occlusion. TCD examination showed the normal flow velocity of vertebrobasilar artery in 8 cases and the significant abnormal in others.　Conclusions　The underlying mechanism of cervical spondylotic vertebral artery insufficiency focuses on the vessel contraction or spasm of vertebral artery caused by nerve irritation resulting from degenerative cervical segmental hypermobility and inflammatory reaction.