烟雾病致脑室出血的脑血管影像学特点

Features of cerebral vascular imaging in Moyamoya disease induced intraventricular hemorrhage

目的探讨烟雾病致脑室出血的脑血管影像学特点。方法回顾性分析64例烟雾病致脑室出血患者的临床资料。结果本组患者DSA检查示,双侧病变58例、单侧病变6例,合并动脉瘤4例;均见烟雾状血管。其中双侧大脑前动脉闭塞4例(6.3%),双侧大脑中动脉闭塞2例(3.1%),脉络膜前动脉远端闭塞41例(64.0%),后交通动脉远端闭塞11例(17.2%),单侧颈内动脉分叉处或大脑前动脉A1段、大脑中动脉M1段闭塞共6例(9.4%)。脉络膜前动脉异常扩张和延长108支(84.4%),后交通动脉异常扩张或延长26支(20.3%)。结论脉络膜前动脉和/或后交通动脉扩张、延长是烟雾病致脑室出血的脑血管影像学特点,并且这也可能是烟雾病致脑室出血的主要病因。

Objective To explore the features of cerebral vascular imaging in Moyamoya disease induced intraventricular hemorrhage.Methods The clinic data of 64 patients with Moyamoya disease induced intraventricular hemorrhage was analyzed retrospectively.Results The DSA examination showed 58 cases with bilateral lesions and 6 cases with unilateral lesions in this group,and there were 4 cases combined with aneurism,while the Moyamoya vessels observed in all cases.There were 4 cases （6.3%） of bilateral anterior cerebral artery occlusion,2 cases （3.1%） of bilateral middle cerebral artery occlusion,41 cases （64.0%） of dismal anterior choroidal artery occlusion,11 cases （17.2%） of dismal posterior communicating artery occlusion,and 6 cases （9.4%） with occlusion in locations of unilateral internal carotid artery shunt,section A1 of anterior cerebral artery or section M1 of middle cerebral artery.There were 108 abnormally dilated or prolonged anterior choroidal arteries （84.4%） and 26 abnormally dilated or prolonged posterior communicating arteries （20.3%）.Conclusion The dilated and prolonged of anterior choroidal artery and/or posterior communicating artery is considered as the imaging features of Moyamoya disease induced intraventricular hemorrhage,and it may be the main etiology of such symptom.