烟雾病的临床特征及诊断分析

Clinical features and diagnostic analysis of Moyamoya disease

目的探讨烟雾病的临床及影像学表现,以及经颅多普勒、数字减影血管造影与磁共振血管成像对该病的诊断。方法分析20例烟雾病,观察其临床及影像学特点。结果20例MRA及9例DSA图像均显示颈内动脉末端、大脑前动脉、大脑中动脉近端狭窄或闭塞,DSA能清晰显示脑底明显增多的异常血管网,并对侧支循环吻合支显示更清晰;7例TCD血流速度增快,频谱紊乱,3例形成涡流。结论MRA能准确诊断烟雾病,且具有无创、经济、实用等特点,DSA在显示细节如烟雾血管、侧支循环等方面优于MRA,TCD可作为异常血管的筛选检查,对需要手术治疗患者,DSA仍为必需的检查方法。

Objective To explore the diagnostic of TCD,DSA and MRA in Moyamoya disease by retrospectively analyzing the clinical and image.Methods 20 Patients who were diagnosed Moyamoya were investigated.The clinical representation,TCD,DSA and MRA changes were observed.Results MRA in 20 cases and DSA in 9 cases showed stenosis or occlusion at the distal bifurcation of internal carotid arteries and proximal portion of the middle or anterior cerebral artery,companied by the apparently abnormal vascular network like puff of smoke.The collateral circulation and anastomotic vessels were showed more clearly on DSA.TCD in 7 cases showed increased velocity of blood flow.Conclusion MRA are helpful to the diagnosis of Moyamoya disease with the non-invasive and feasible advantage.DSA is better than MRA in showing the details such as smoke-like vessels and collateral circulation.TCD can be a alternative tool for detecting abnormal vessels.DSA must be done if the patients need an operation.