多层螺旋CT血管成像在烟雾病诊断中的应用

The evaluation of multislice spiral computed tomography angiography in the diagnosis of moyamoya disease

目的探讨多层螺旋CT血管成像（MSCTA）在烟雾病诊断中的价值以及应用前景。方法回顾性分析10例烟雾病患者的MSCTA及数字减影血管造影（DSA）的影像学资料。结果MSCTA可清晰显示狭窄、闭塞以及异常增多的脑血管。容积重建有利于显示病变血管与周围结构的空间关系，综合最大密度投影法重建和多曲面重建图像分析可清晰显示异常增多的脑血管，即烟雾状血管。MSCTA对狭窄及闭塞血管的检出率为66．2％（53/80）；DSA对狭窄及闭塞血管的检出率为67．5％（54／80），两者比较差异无统计学意义（P〉0．05）。MSCTA对颅底异常血管网的显示及分布情况与DSA大致相似。结论MSCTA诊断烟雾病的灵敏度高，是早期诊断烟雾病的重要依据，早期诊断、及时治疗是改善烟雾病患者预后的有效方法。

Objective To evaluate the diagnostic value of the multislice spiral computed tomography angiography （MSCTA） in the diagnosis of moyamoya disease and explore its future application. Method The image data of 10 patients with moyamoya disease undertaken MSCTA and digital subtraction angiography （DSA） were reviewed analysis. Results MSCTA could clearly show stenosis, multiple occlusion or abnormalities of the cerebral vessels. Volume-rendering helped to show the relationship between the abnormal vessels and the surrounding tissues. Combined maximum intensity projection （MIP） and muhiplanar reconstruction （MPR） images could clearly show abnormally increased vessels （moyamoya disease vessels ）. The rate of occlusion and stenosis showed by MSCTA were 66.2% （53/80）and 67.5%（54/80）by DSA. There was no significant difference between the two methods （P 〉 0.05 ）. The images of MSCTA were basically same as those of DSA. Conclusions MSCTA is sensitive in diagnosing moyamoya disease, which is an important basis for early diagnosis. Early diagnosis and treatment is effective in improving prognosis of moyamoya disease.