“烟雾病样”血管病变全脑血管造影分析  

Analysis of Cerebral Angiography for Moyamoya Disease-like Vascular Abnormality

作　　者：刘俊[1] 周政[1] 陈锦华[1] 杨辉[1] 

机构地区：[1]第三军医大学附属新桥医院神经外科,重庆400037

出　　处：《中国临床医学》2007年第3期298-301,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨"烟雾病样"血管病变的脑血管造影(DSA)表现特征;方法:回顾分析43例经脑血管造影证实的"烟雾病样"血管病变的影象学特征,其中明确为烟雾病40例(93%),其它疾病引起的烟雾病样血管改变3例(7%)。临床表现脑出血26例(60.5%),脑缺血14例(32.5%),头痛3例(7%),均行保守治疗。结果:43例患者的DSA表现特征:(1)均表现为不同程度的单侧或双侧颈内动脉床突上段及大脑前、大脑中动脉狭窄变细或闭塞;(2)均表现为同侧或双侧颅底大片血管增生;(3)部分病例颈内外动脉分支血管吻合支形成。结论:烟雾病的DSA表现特征为双侧颈内动脉狭窄或闭塞,伴有大脑中动脉或前动脉的狭窄或闭塞,颅底有不同程度异常增生的血管网,而单侧烟雾样血管病变则多有明确病因。成年人烟雾病以侧脑室出血和脑出血多见,颈动脉狭窄可能导致颅内烟雾样血管改变,DSA是明确诊断的首选方法。Objective：To explore the features of digital subtraction angiography（DSA） for moyamoya disease （MMD） of llke vascular abnormality. Methods： A retrospective review of the features of DSA was conducted among 43 patients suffering from MMD-like vascular abnormality. 40 cases （93 % ） were definitely MMD and 3 cases （7 % ） were MMD-like vascular abnormaolity caused by other diseases. All of the patients were treated conservatively and the clinical features were intracerebral hemorrhage in 26 cases （60. 5%）, intracerebral ischemia in 14 cases （32.5%） and headache in 3 cases （7%）. Results： The characteristics of DSA for all of the cases were： （1） All cases were detected vary extents steno-occlusive change in the lateral or bilateral internal carotid artery, and the middle or anterior cerebral artery; （2） There were much of ＂puff of smoke＂ vessels in the circulation of the circle of Willis; （3）Vascular anastomosis occured in the external and internal carotid artery. Conclusion： Moyamoya disease is characterized by the steno-occlusive change in the bilateral internal carotid artery and the middle and anterior cerebral artery and there are much of ＂puff of smoke＂ vessels in the circulation of the circle of Willis. But the MMD-like vascular abnormality located in one side usually have definitive etiological factor. Intraventricular hemorrhage and intracerebral hemorrhage were the dominat finding on Adults MMD. Stenosis of the cervical carotid artery may be the reason of MMD-like state. DSA is the best diagnosis method for MMD.

关 键 词：烟雾病 脑血管造影 

分 类 号：R814.4[医药卫生—影像医学与核医学]