烟雾病患者临床与脑血管造影特点分析

Analysis of the clinical and digital subtraction radiography imaging features of moyamoya disease on 45 patients

目的分析烟雾病(MMD)患者的临床和脑血管造影(DSA)特点。方法将45例烟雾病患者分为少年组(14例,年龄≤15岁)和成年组(31例,年龄>15岁),并对两组患者的临床和脑血管造影特点进行分析。结果 45例患者中双侧颈内动脉均有不同程度的狭窄闭塞,伴有双侧大脑前动脉、中动脉狭窄并不全闭塞或者闭塞的23例,单侧大脑前、中动脉狭窄并不全闭塞12例,单侧大脑前、中动脉完全闭塞1例,单侧大脑中动脉闭塞5例,单侧大脑前动脉闭塞4例。其中,少年组14例中有12例表现为缺血性脑卒中,成年组31例中21例表现为出血性脑卒中。所有病例均可清晰得显示出脑底明显增多的异常血管网、吻合血管及动脉瘤等病变。结论烟雾病临床表现多样,少年常表现为缺血性卒中,成年常表现为出血性卒中,DSA检查为诊断烟雾病的金标准,早期诊断、及时治疗可有效得减轻临床症状。

Objective To analyze the clinical and digital subtraction radiograph （DSA） imaging features of moyamoya disease （ MMD ）. Methods Forty five patients diagnosed correctly by DSA were divided into teenager group（ 14 cases, aged younger than 15） and adult group（31 cases, aged older than 15 ）, the clinical features of two groups were analyzed in this study. Results Bilateral internal carotid artery have different degrees of stenosis and occlusion in 45 cases, bilateral anterior cerebral artery and middle cerebral artery have stenosis and occlusion in 23 cases, unilateral anterior cerebral artery and middle cerebral artery have steuosis and incomplete occlusion in 12 cases, unilateral anterior cerebral artery and middle cerebral artery blocked completely in 1 case, unilateral middle cerebral artery blocked completely in 5 cases, unilateral anterior cerebral artery a blocked completely in 4 case. Twelve cases （12/14） in teenager group showed ischemic stroke, 21 cases （ 21/31 ） showed hemorrhagic stroke, All cases showed clearly of the collateral circulation and anastomotic vessels and aneurysm. Conclusions The clinical symptoms of MMD show various forms. Teenagers display ischemie stroke while adults display hemorrhagic stroke. DSA is the golden standard of diagnose. Early diagnosis and promptly medical treatment may lighten clinical symptoms.