烟雾病的DSA、CT和MRI诊断

DSA, CT and MRI in Diagnosis of Moyamoya Disease

目的：评价DSA、CT和MBJ对烟雾病的诊断价值。资料和方法：20例病人急性颅内出血起病13例，病情缓慢进展7例，20例DSA检查前有19例行CT检查，2例行MRI检查，1例在DSA检查后行MRI检查。结果：DSA检查具有下列特征性表现：①受累动脉狭窄或闭塞；②脑底部烟雾状毛细血管网；③大量的侧支循环形成。CT14例发现脑室内或蛛网膜下腔出血，3例儿童提示有脑组织内病变，2例表现正常。MRI检查可发现脑内血管性病变。结论：DSA检查是诊断本病的主要手段，具有明显的优点。CT检查对于急性病人一般只能提示出血部位，对于慢性儿童病人常能提示有脑组织内病变。MRI检查，因本组病例太少，其对本病的诊断价值有待进一步探讨。

To assess the value of DSA,CT and MRI in the diagnoses of Moyamoya disease. Materials and Methods:20 patients were evaluated: acute intracranial bleeding in 13 patients and chronic progressive diease in 7. 19 patients underwent CT before DSA,2 MRI before DSA, 1 MRI after DSA. Results:DSA showed characteristic manifestations: ① stensis or occlusion of involved arteries; ②moyamoya vessels from supraseller supraseller cistern to cerebral base;③ development of collateral vessels,CT showed hemorrhage in cubarachnoidal cistern or/and cerebral ventricle in 14 patients, changes in cerebral parenchyma in three children, normal in 2 patients. MRI could show intracerebral vascular changes. Conclusion : DSA is the main method for the diagnosis of Moyamoya disease, CT can depict the localims of cerebral hemorrhage in emergency patients and the lesims of chronic disease in children. The value of MRI in diagnosing Moyamoya disease needs further studies in larger number of cases.