256层螺旋CT动态容积扫描在烟雾病诊断中的应用价值

The applied value of 256 spiral CT dynamic volume scanning in the diagnosis of moyamoya disease

目的探讨256层螺旋CT动态容积扫描在烟雾病诊断中的价值。方法选取经256层螺旋CT动态容积扫描的烟雾病患者23例（烟雾病组），有脑血管病症状，但脑内动脉无狭窄患者18例（对照组），分别进行容积再现（VR）、最大密度投影（MIP）和脑CT灌注成像。对大脑前、中、后动脉分布区脑CT灌注参数进行定量测量并做统计分析。结果VR、MIP能很好地显示烟雾病病变血管部位、狭窄程度及颅底异常血管网改变。与对照组比较，烟雾病组患者大脑前动脉分布区脑血容量（CBV）增大[（8．46±0．91）ml／100g比（2．92±0．72）ml／100g]、达峰时间（TTP）延长[（30．27±5．02）s比（24．83±4．07）s]，差异有统计学意义（P〈0．01），但脑血流量（CBF）、平均通过时间（MTF）比较差异无统计学意义（P〉0．05）；大脑中动脉分布区CBV增大[（8．06±1．05）ml／100g比（6．08±0．56）ml／100g]，MTT、TTP延长[（6．34±1．01）s比（3．83±0．83）s、（32．06±2．55）s比（25．83±2．34）s]，差异有统计学意义（P〈0．01），但CBF比较差异无统计学意义（P〉0．05）；大脑后动脉分布区脑CT灌注参数两组比较差异无统计学意义（P〉0．05）。结论256层螺旋CT动态容积扫描在形态学与功能学相结合，对烟雾病诊断有重要的指导意义。

Objective To discuss the value of 256 spiral CT dynamic volume scanning in the diagnosis of moyamoya disease. Methods Twenty-three patients with moyamoya disease undergoing 256 spiral CT dynamic volume scanning （moyamoya group） were selected,and 18 patients having cerebrovascular disease symptoms,but the brain artery without stenosis （control group） were also selected. The volume reconstruction （VR）, maximum intensity projection （MIP） and cerebral CT perfusion imaging was displayed.The cerebral CT perfusion imaging parameters of anterior, middle, posterior cerebral artery were measured and analyzed. Results VR,MIP could well reproduce lesion location, degree of stenosis and skull base abnormal vascular network change. Compared with control group, the cerebral blood volume （CBV） was increased [（8.46 ±0.91） ml/100 g vs. （2.92 ±0.72） ml/100 g], time to peak （TIP） was increased [ （30.27 ± 5.02） s vs. （24.83 ± 4.07） s ] in anterior cerebral artery, and there was significant difference （P 〈 0.01 ）,but there was no significant difference in the cerebral blood flow （CBF）, the mean transit time （MTT）（P 〉 0.05 ）. Compared with control group, CBV was increased [ （8.06 ± 1.05 ） ml/100 g vs. （6.08 ± 0.56） ml/100 g l, MTT, TFP was increased[ （6.34 ± 1.01 ） s vs. （3.83 ± 0.83） s, （32.06 ± 2.55 ） s vs. （25.83 ± 2.34） s] in middle cerebral artery, and there was significant difference （P〈 0.01 ）,but there was no significant difference in CBF （P 〉 0.05）. Compared with control group, there was no significant difference in the cerebral CT perfusion imaging parameters of posterior cerebral artery （P 〉0.05）. Conclusion 256 spiral CT dynamic volume scanning can be combined with morphology and function imagings, and has important guiding significance for diagnosis of moyamoya disease.