烟雾病的代偿机制和影像学表现分析

Blood Compensatory Mechanism and Digital Subtraction Angiography of Moyamoya Disease

目的探讨烟雾病的代偿机制及其影像学表现。方法对2011年11月—2012年7月收治的22例经常规数字减影血管造影确诊的烟雾病患者的代偿机制及影像学表现进行回顾性分析及总结。结果烟雾病患者大多存在丰富的颅内外侧支循环代偿,包括后循环向前循环代偿及颅外向颅内的代偿。其中通过前交通动脉使对侧大脑前动脉显影6例、后交通动脉增粗14例、大脑后动脉代偿增粗10例、脑膜中动脉代偿8例、脉络膜后动脉及胼胝体背动脉代偿增粗15例、软脑膜动脉代偿7例、眼动脉代偿增粗5例。结论术前了解患者的颅内外侧支循环代偿机制很重要,在进行手术治疗时,避免损伤代偿血管,加重患者病情。同时通过患者代偿机制影像学表现的分析,评价手术治疗的意义。

Objective To discuss the blood compensatory mechanisms and imaging features of moyamoya disease and its significance in surgical treatment.Methods Blood compensatory mechanisms and imaging features by digital subtraction angiography of 22 moyamoya disease patients were collected from November 2011 to July 2012,and retrospectively analyzed.Results Prominent collateral circulation was found in most moyamoya disease patients,including anterior cerebral circulation blood supply from posterior cerebral circulation or extra-cranial arteries.Through the anterior communicating artery,the contralateral anterior cerebral artery imaging in 6 cases,the oposterior communicating artery thickening in 14 cases,thickening of the posterior cerebral artery compensatory in 10 cases,compensatory meningeal artery in 8 cases,posterior choroidal artery and dorsal artery of the corpus callosum compensatory increase coarse 15 cases,compensatory pial artery in 7 cases,ophthalmic artery compensatory thickening in 5 cases.Conclusion It is important to analyze the collateral circulation preoperatively to avoid the surgical damage on the collateral vessels.At the same time,it is of great significance to evaluate the surgical treatment on moyamoya disease via analyzing the imaging features of collateral circulation.