CT、MRA及DSA对成人型烟雾病的诊断价值

Clinical values of CT,MRA and DSA in adult Moyamoya's Disease

目的探讨CT、MRA、DSA在成人型烟雾病(Moyamoya's Disease,MMD)中的临床应用价值。方法14例成人型烟雾病均行CT、MRI平扫及MRA检查,其中3例行数字减影血管造影(DSA),回顾性分析以上病人的影像资料。结果9例患者CT表现为颅内出血,以脑实质和脑室出血为主,5例表现为脑梗塞灶,MRA显示其中11例基底区均有不同程度异常血管网形成,病变段血管狭窄或闭塞,3例可疑病例进一步行DSA检查,亦表现为颅底侧支循环的毛细血管异常增多。结论CT可初步提示MMD存在的可能,MRA可作为该病的首选影像学检查方法。DSA在疑难病例的诊断方面依然具有其价值,到目前为止,MRA仍不能完全替代DSA。

Objective To explore the clinical values of CT,MRA and DSA in adult Moyarnoya＇s Disease. Methods 14 patients confirmed with adult Moyamoya＇s disease were chosed, all have been scanned by CT,MRI and MR angiography （MRA）, 3 cases of them have also been received DSA. Results 9 cases showed cerebral hemorrhage, mainly occurred in the cerebral parenchymatous tissue, while 5 cases showed cerebral infarction. MRA demonstrated that 11 cases of them formed different level abnormal vascular nets in the basal ganglia, hemadostenosis stenosis or occlusion of the pathological portions. 3 cases suspected in MRA were diagnosed by DSA, also showed the extra abnormal vascular nets in the basalis compensatorycirculation. Conclusion CT scan can suggest the existence of MMD, and MRA can be selected as the best imageology methodof it. DSA still shows its value in intractable cases. MRA cannot yet replace DSA completely in MMD diagnosis at present,