磁共振影像特点在缺血型烟雾病与出血型烟雾病中的对比分析  

Comparative analysis on the MR imaging characteristics between Ischemic moya-moya disease and hemorrhagic moya-moya disease

作　　者：谢安明[1] 丁耀军[1] 李功杰[2] 

机构地区：[1]解放军第94医院放射科,江西南昌330002 [2]解放军第307医院放射科,北京100071

出　　处：《中国医学装备》2015年第1期35-38,共4页China Medical Equipment

基　　金：全军医药卫生科研基金(MS074)"64排VCT脑灌注成像联合血管成像对烟雾病血流动力学研究";江西省卫生厅科技计划(20142083)"64排VCT脑灌注成像联合血管成像对烟雾病的研究"

摘　　要：目的:分析缺血型烟雾病与出血型烟雾病磁共振(MR)影像特点的差别,提高预测烟雾病出血的概率。方法:回顾性分析64例烟雾病患者的临床及MR影像学资料。结果:64例烟雾病患者中,最大年龄49岁,最小年龄26岁,平均年龄38.2岁;其中缺血型烟雾病患者21例(占32.8%),以额叶及顶叶分布为主;出血型烟雾病患者43例(占67.2%),以背侧丘脑(共28例,占65.1%)、基底节区(共9例,占20.9%)、单纯脑室内(共4例,占9.3%)以及单纯蛛网膜下腔(共2例,占4.6%)分布为主。出现脑底烟雾状异常血管网、脉络膜前动脉及胼胝体背侧动脉增粗、大脑后动脉与皮质软脑膜血管增粗、眼动脉增粗、颈外动脉分支血管增粗在缺血型烟雾病及出血型烟雾病分别为15例共28侧支(占71.4%)和38例共62侧支(占88.4%)、12例共24侧支(占57.1%)和35例共45侧支(占81.4%)、8例共16侧支(占38.1%)和30例共58侧支(占69.8%)、5例共10侧支(占23.8%)和13例共24侧支(占30.2%)、7例共11侧支(33.3%)和27例共54侧支(62.8%)。结论:迂曲扩张的脉络膜动脉及颅底异常增生的血管网是烟雾病发生出血的主要原因。Objective： To improve the accuracy of forecasting hemorrhagic moya-moya disease by analyzing the difference in MR imaging between ischemic moya-moya disease and hemorrhagic moya-moya disease. Methods： Retrospective analysis was conducted of clinical and MR imaging data of 64 patients with moya-moya disease between 2009 and 2014 years in Hospital 94 of PLA. Results： Among the 64 patients aged 26 to 49 （average age was 38.2）, 21 cases （32.8%） were diagnosed with ischemic moya-moya diseases, while 16 cases （76.2%） diagnosed with hemorrhagic moya-moya diseases, ischemic lesions were distributed mainly in frontal and parietal area, while hemorrhagic lesions were mainly distributed in the dorsal thalamus （28 cases, 65.1%）, in the basal ganglia （9 cases, 20.9%）, in the simple intraventricular （4cases, 9.3%） and in pure subarachnoid （2 cases, 4.6%）. In the ischemic-typed moyamoya disease and hemorrhagic-typed moyamoya disease, cerebral bottom dorsal smoke abnormal vascular network, anterior choroidal artery and callosal artery thickening of the posterior cerebral artery, cortical pial vascular thickening, thickening of vascular branches of ophthalmic artery and external carotid artery thickening were respectively occurred in 15 cases of 28 branch （71.4%） and 38 cases of 62 branches （88.4%）, 12 cases with 24 branches （57.1%） and 35 cases with 45 branches （81.4%）, 8 cases with 16 branches （38.1%） and 30 cases with 58 branches （69.8%）, 5 cases with 10 branches （23.8%） and 13 cases of the 24 branch （30.2%）, 7 cases with 11 side branches （33.3%） and 27 patients with 54 branch （62.8%）. Conclusion：The tortuous and dilated choroid artery and abnormal hyperplasia vascular network in skull base are the main causes of bleeding in moya-moya diseases.

关 键 词：缺血型 出血型 烟雾病 MR影像 

分 类 号：R445.2[医药卫生—影像医学与核医学]