320排动态容积CT血管造影在烟雾病诊断中的应用价值  

Application of 320-row volume CT angiography in the diagnosis of Moyamoya disease

作　　者：叶贤旺[1] 黄求理[1] 任大卫[1] 潘宇宁[1] 张杰[1] 林云为[1] 

机构地区：[1]宁波市第一医院影像科,浙江宁波315010

出　　处：《实用放射学杂志》2012年第10期1502-1505,共4页Journal of Practical Radiology

摘　　要：目的探讨320排动态容积CT血管造影（4I）JcTA）在烟雾病诊断中的应用价值及优势。方法对320排CT进行动态容积扫描的22例烟雾病患者图像进行减影、去骨，形成4D-CTA图像，其中5例患者CTA检查后进行了DSA检查，由2名经验丰富的主治以上医师对5例患者的CTA及DSA图像分为9组41段进行评价打分，5分（血管显示清晰，管壁光整，不带骨质）、4分（血管显示清晰，管壁欠光整或带少许骨质）、3分（血管显示尚清晰，管壁不光整，带部分骨质，但尚可诊断）、2分（血管模糊，管壁不光整，带较多骨质，难以诊断）、1分（血管难以显示，带大量骨质）、0分（血管无显示或者闭塞）。用t检验比较动脉期4D-CTA和DSA显示9组41段血管有无差异。结果本组22例经4D-CTA检查均可明确诊断为烟雾病，其中5例患者4D-CTA与DSA显示血管情况相仿，2种方法间差异无统计学意义（P〉O．05）。临床主要表现为出血性症状11例，缺血性症状11例；两侧颈内动脉末端均明显累及13例，以左侧累及为主5例，以右侧累及为主4例，椎-基底动脉狭窄5例，代偿性扩张9例，无明显改变8例；1例合并大脑后动脉P1段动脉瘤；检出脑膜中动脉和／或颈外动脉分支颞浅动脉侧支供血8例。结论320排4D-CTA是一种快速、安全、有效的检查方法，能替代DSA作为烟雾病确诊检查方法。Objective To evaluate the clinical value of 4-dimensional CT angiography （dynamic 4D-CT.A） with 320-row detector volume CT in the diagnosis of Moyamoya disease Methods 22 patients suspected with Moyamoya disease were imaged at a 320-row detector volume CT. All the original datas were processed with subtraction method. Five patients were examined by the DSA after CTA. The image datas of five patients who were diagnosed as Moyamoya disease by 4D-CTA and DSA were analyzed by two experi- enced radiologists. Intracranial vessels were divided into nine groups 41 segments. And the image quality of each segments were classified and scored：5 points （blood vessels clear, the vessel wall smooth, without bone）,4 points（blood vessels clear, the vessel wall not smooth enough, or with a little bone）, 3 points（blood vessels is still clear,the vessel wall is not smooth or with a little bone,but meet the diagnostic requirements）, 2 points（vascular vague, the vessel wall is not smooth, with more bone, difficult to di- agnose） ,1 point（blood vessels difficultly be displayed, with a lot of bone）, 0 point （blood vessels can not be displayed or occlu- sion）, then t test was used to compare the differeences between two mothods. Results The diagnosis of moyamoya disease could be confirmed in all of 22 patients by 4D-CTA examination ,of which 5 patients showed similar vascular findings by 4D-CTA and DSA, there were no significant differences between CTA and DSA in diagnosing Moyamoya disease （P〉0.05 ）. The main clinical manifes- tations included bleeding symptoms in 11 cases and ischemic symptoms in 11 cases. CTA showed narrowing of the distal ends of bi- lateral carotid arteriae in 13 cases, in which, the left and right sides of the internal carotid arteriae mainly involved in 5 and 4 cases, respectively, vertebral-hasilar artery stenosis in 5 cases, vertebral-basilar artery compensatory enlargement in 9 cases, no significant changes in 8 cases, in combination with aneurysm of Pl segment of posterior c

关 键 词：脑 烟雾病 计算机体层成像 血管造影 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]