成人出血型烟雾病的CTA表现

CTA features of adult hemorrhagic Moyamoya disease

目的:探讨成人出血型烟雾病(Moyamoya病)的CTA表现特征。方法:回顾性分析78例诊断为成人Moyamoya病的临床及CTA资料。结果:178例成人Moyamoya病中出血型的发生率为47.4%(37/78);不同性别发病率和发病年龄之间差异均无统计学意义(P>0.05)。2出血原因与CT表现:动脉瘤破裂出血发生率16.2%(6/37),以蛛网膜下腔出血(66.7%)为主;脉络膜前动脉破裂出血发生率48.6%(18/37),其中66.7%表现为脉络膜前动脉扩张并伴有后交通动脉扩张,以脑实质出血破入脑室(50%)和单纯脑室出血(27.8%)为主;异常增生的烟雾状血管破裂发生率35.1%(13/37),以单纯脑实质出血(38.5%)和脑实质出血破入脑室(30.8%)为主。结论:依据CTA的表现,结合出血发生的类型和部位,能够进一步推断Moyamoya病出血的原因,为进一步的干预治疗提供依据。

Objective： To explore the characteristics of CT angiography （CTA） with adult hemorrhagic Moyamoya disease. Methods.. The clinical and imaging data of 78 adult patients with Moyamoya disease were retrospectively analyzed. Results： In 78 cases,there were 37 cases （47.4%） diagnosed as hemorrhagic Moyamoya disease. The incidence of different gender and age was not statistically significant （ P 〉0.05）. For the causes and CT findings of hemorrhage, there were 6 cases with aneurysm rupture and subarachnoid hemorrhage was the main type of bleeding. There were 18 cases with anterior choroidal artery rupture, 12 cases of them following dilation of the anterior choroidal artery and posterior communicating artery, cerebral hemorrhage ruptured into ventricle （50%） and intraventricular hemorrhage （27.8%） were the main types of bleeding. There were 13 cases （35.1%） with smoke vessels rupture, cerebral hemorrhage （38. 5 %） and cerebral hemorrhage ruptured into ventricle （30.8%） were the main types of bleeding. Conclusion： The CTA findings and the type of bleeding can determine the bleeding causes of hemorrhagic Moyamoya disease, so as to provide evidences for further intervention therapy.