烟雾病的影像学征象(附27例报告)

Imaging Findings of Moya moya Disease (Analysis of 27 Cases)

目的 分析２７例烟雾病脑血管造影、ＣＴ、ＭＲＩ及ＭＲＡ表现。方法 脑血管造影２３例，ＣＴ检查２３例，ＭＲＩ检查１２例，ＭＲＡ检查６例。结果 （１） 出现颈内动脉、大脑前动脉、大脑中动脉狭窄或闭塞及颅底异常血管网伴脑膜侧支循环分别为６３％ 、６６．７％ 、９６．３％ 、１００％ ；脑梗死、脑出血、脑萎缩及脑室扩大分别为７０．４％ 、１４．８％ 、１４．８％ 、１８．５％ 。（２） 脑血管造影、ＣＴ平扫、ＭＲＩ及ＭＲＡ对烟雾病的诊断率分别为１００％ 、０％ 、５０％ 、１００％ 。结果 ＣＴ及ＭＲＩ主要用于显示烟雾病的脑实质改变，而脑血管造影和ＭＲＡ用于显示该病的脑血管改变。ＭＲＡ是怀疑此病后首选检查方法，若患者准备手术。

Objective To analyze the findings of conventional cerebral angiography (CCA), CT, MRI and MRA in the diagnosis of 27 cases with moya moya disease (MMD). Methods 23 cases underwent CCA and 23 cases CT examination, 12 cases were examined by MRI and 6 cases by MRA. Results (1) The occlusion or stenosis of the terminal portion of the internal carotid artery (ICA) and the proximal portion of anterior and middle cerebral arteries (ACA, MCA) in all cases were respectively 63%, 66.7%, 96.3%, The moya moya vessels (MVS) and other collaterals were 100%; for cerebral infarctions, hemorrhage, atrophic changes, ventricular dilation were respectively 70.4%, 14.8%, 14.8%, 18.5%. (2) The positive rate of CCA, CT, MRI and MRA for diagnosing moya moya disease were 100%, 0%, 50%, 0% respectively. Conclusions CT and MRI demonstrated the cerebral parenchymal changes of MMD, MRA and CCA demonstrated cerebral arteries changes, MRA should be performed first when MMD was suspected and CCA should be reserved for further examination if surgery was planned.