成人出血型烟雾病磁共振成像的研究进展

Applications of magnetic resonance imaging in adult patients with hemorrhage moyamoya disease

数字减影血管造影(digital subtraction angiography,DSA)是烟雾病诊断的金标准,但其是一种有创检查且费用高,不适合筛选及复查的患者;CT血管造影(CT angiography,CTA)是烟雾病诊断的重要方法,但患者会受到一定X线辐射剂量及对比剂的伤害;超声对于烟雾病颅内血管的诊断意义不大。近年来,随着磁共振技术的发展及成熟,其形态学成像方法可显示脑实质及异常血管的病变,其功能学成像方法可监测脑血流动力学的改变,诊断优势在于多对比度、多模态、无创及无辐射。本文通过综述磁共振成像技术对出血型烟雾病诊断及评估的研究现状,为临床医生在烟雾病的诊断及治疗上提供重要的参考价值。

Cerebral angiography is still the gold standard for the diagnosis of moyamoya disease(MMD),however,it isn’t suitable for patients that is necessary for screen and follow up because of an invasive and expensive way.CT angiography(CTA)is considered essential for the diagnosis,but it is harmful for the body.Ultrasound is less meaning for the exam of MMD.With the advanced development of magnetic resonance imaging,the way of morphological examination is helpful for localizing ischemic and hemorrhagic lesions in the brain parenchyma and identifying stenotic lesions in the ends of the carotid artery.And the functional method is indispensable for evaluating cerebral hemodynamics of the patients with MMD.Moreover,MRI is a multi-contrast and multi-modality method to diagnose MMD,it’s also a non-invasive and safe way.Here,we review the progress of MRI in terms of diagnosis and assessment in adult patients with hemorrhage MMD in order to provide a significant clinical reference for diagnosis and operation.