动脉粥样硬化性大脑中动脉狭窄继发Moyamoya综合征的脑血管病变及侧支循环分布模式

Charactics of cerebrovescular lesion,collateral circulation in Moyamoya syndrome secondary to intracranial atherosclerotic disease

目的：探讨动脉粥样硬化性大脑中动脉狭窄继发 moyamoya 综合征的脑血管病变及侧支循环分布模式。方法收集2010年8月~2013年12月经 DSA 证实动脉粥样硬化性大脑中动脉狭窄患者26例。评估 moyamoya 血管网建立与颅内血管病变及软脑膜侧支循环开放度之间的关系。结果26例患者中 moy-amoya 综合征组17例，非 moyamoya 综合征组9例。moyamoya 综合征组4例患者在 MCA 闭塞侧 A1段表现为细小或缺如，而非 moyamoya 综合征组9例 A1段表现正常。moyamoya 综合征组11例在 MCA 一侧或对侧的 ACA 上发现动脉粥样硬化性狭窄或闭塞病变，而非 moyamoya 综合征组未发现上述病变（P =0.004）。非 moyamoya 综合征组所有患者均显示自 ACA 到达 M1或 M2节段足够的软脑膜侧支循环，而 moy-amoya 综合征组仅有8例（P =0.012）。结论动脉粥样硬化所致的 moyamoya 血管网重建可能与软脑膜侧支循环建立不佳有关。

Objective To investigate the charactics of cerebrovescular lesion,collateral circulation in Moyamoya syndrome secondary to intracranial atherosclerotic disease.Methods 26 subjects were identified by digital subtraction angiography between August 2006 and December 2013.Evaluating the correlation between moyamoya vessels ,intracranial arterial lesions and the degree of leptomeningeal anastomosis.Results 1 7 pa-tients had moyamoya vessels.The presence of moyamoya vessels was associated with ipsilateral or contralateral anterior cerebral artery stenosis to the occluded MCA （P =0.004）and poor development of anterior leptomen-ingeal anastomosis （P =0.012）.It was also associated with vascular lesions involving more than one intracrani-al branch vessel in patients with moyamoya syndrome secondary to atherosclerosis.Conclusions Moyamoya vessels might be associated with poorly developed leptomeningeal collateral vessels.