成年型烟雾病多层螺旋CT造影分级及侧支循环分布41例分析  

Multi-slice CT angiography classification of adult type moyamoya disease and collateral circulation distribution in 41 cases

作　　者：王立莎[1,2] 朱磊[1,2] 张悦[1,2] 

机构地区：[1]湖北医药学院附属襄阳医院 [2]襄阳市第一人民医院CT室,441000

出　　处：《疑难病杂志》2014年第5期474-477,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的通过多层螺旋CT血管造影（MSCTA）技术探讨成人型烟雾病（MMD）分级及侧支循环的分布模式。方法 收集41例烟雾病患者的临床资料及MSCTA资料,依照Suzuki 6级分级标准评估患者的血管级别,对应分析患者的侧支循环分布。结果 41例烟雾病患者中,烟雾病早期（SuzukiⅠ～Ⅱ级）患者11例（26.8%）,主要表现为大脑前-软脑膜动脉-大脑中动脉,大脑中-软脑膜动脉-大脑前动脉侧支循环;中期（SuzukiⅢ～Ⅳ级）患者25例（61.0%）,主要表现为异常烟雾状血管网形成及脉络膜前动脉扩张、延长,后交通动脉开放、扩张、延长-大脑后动脉-软脑膜动脉-大脑前和/或大脑中动脉,大脑后动脉-软脑膜动脉-大脑前和/或大脑中动脉,脉络膜后动脉-胼周后动脉-大脑前动脉侧支循环;晚期（SuzukiⅤ～Ⅵ级）患者5例（12.2%）,主要表现为大脑后动脉-软脑膜动脉-大脑前或大脑中动脉,眼动脉、颞浅动脉、脑膜中动脉与大脑前、中动脉终末皮质支沟通,上颌动脉与颅底皮质支沟通,枕动脉与枕叶皮质支沟通。结论 MSCTA能够准确地评价烟雾病侧支循环的分布模式,其中以SuzukiⅢ～Ⅳ级患者比例较高,而颈外动脉向颅内代偿出现在烟雾病中、晚期居多。Objective To investigate adult moyamoya disease（MMD） classification and collateral circulation distribution pattern through the multi-slice CT angiography（MSCTA）.Methods Collected 41 cases of patients with MMD MSCTA clinical data and information to assess the level of the patient＇s blood vessels and the distribution of collateral circulation in accordance with Suzuki 6-level classification standard.Results 41 cases of patients with MMD,11 patients with early（Suzuki I-II grade） moyamoya disease（26.8%）,mainly for the front of the brain-pial artery-middle cerebral artery,middle cerebral artery-pial artery-anterior cerebral artery collateral circulation;interim（Suzuki Ⅲ-Ⅳ grade） in 25 patients（61.0%）,mainly as abnormal vascular network formation and smog-like anterior choroidal arteries,prolonged traffic artery open after expansion,to extend-the posterior cerebral artery-the pia mater artery-anterior and/or middle cerebral artery,posterior cerebral artery-pial artery-anterior and or middle cerebral artery,posterior choroidal artery-peri-corpus posterior artery-anterior cerebral artery collateral circulation;late（Suzuki Ⅴ-Ⅵ grade） in 5 patients（12.2%）,mainly for the posterior cerebral artery-pial artery-anterior cerebral or middle cerebral artery and ophthalmic artery,superficial temporal artery,middle meningeal artery and middle cerebral artery terminal cortical branch communication,communication with the base of the skull maxillary artery branch cortex,occipital cortex communicate with the occipital artery branch.Conclusioil MSCTA can accurately evaluate the distribution pattern of collateral circulation in moyamoya disease,in which Suzuki III-IV grade occupied higher proportion,while the external carotid artery to the brain compensatory in moyamoya disease occurred in the late stage.

关 键 词：烟雾病 侧支循环 X线计算机体层摄影术 血管造影 

分 类 号：R743[医药卫生—神经病学与精神病学]