磁共振成像在烟雾病诊断中的应用价值探讨

The Application Value of MRI and MR Angiography in the Diagnosis of Moyamoya Disease

目的：旨在探讨磁共振成像在烟雾病诊断中的临床应用价值。 材料和方法：对７ 例烟雾病病人的ＭＲＩ和Ｍ ＲＡ 征象进行分析。ＭＲＩ检查包括应用ＳＥ 序列Ｔ１ 加权像和Ｔ２ 加权像；ＭＲＡ 检查采用三维时间飞跃法，对源图像做最大强度投影重建血管影像。 结果：所有病例的ＭＲＩ和ＭＲＡ 均表现为双侧颈内动脉末端、大脑中动脉和大脑前动脉狭窄或闭塞，颅底部纤细的侧枝循环血管呈网状分布，脑膜中动脉和眼动脉增粗，５ 例有脑实质内急性或亚急性出血；２ 例合并脑梗塞。 结论：ＭＲＩ能全面显示脑实质内的各种影象病理改变，ＭＲＡ 更为直观地显示颅内血管改变。ＭＲＩ与ＭＲＡ 的结合应用对烟雾病诊断有重要价值。

Purpose To investigate the clinical application of MRI and MR angiography in the diagnosis of moyamoya disease. Materials and methods To analysis the MRI and MRA features of seven cases who suffered from moyamoya disease. MRI examination included T1 weighted imaging and T2 weighted imaging of spin echo sequence. MRA used 3 dimensional time of flight method and demonstrated the intra cranial arteries with the maximum intensity projection (MIP) of the source images. Results The findings included narrowing and occlusion of the both sides of supraclinoid portion of internal cartoid arteries (ICA) as well as the stems of the anterior cerebral arteries (ACA) and middle cerebral arteries (MCA). The extensive collateral vessels were also found at the base of brain just like “puff of smoke”. The middle meningeal arteries and optic arteries was also becoming enlargement and formed the collateral with the intra cranial arteries. Five cases had acute or subacute hemorrhage and 2 cases had significant cerebral infarction. Conclusion MRI can demonstrate all pathologic changes in the cerebral parenchyma following the moyamoya disease. MRA give the detail and panorama displaying of the arteries changes. MRI and MRA are valueable in the diagnosis of moyamoya disease.