成年人缺血型烟雾病的CT成像特点  

Characteristics of CT imaging of adult ischemic moyamoya 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]军事医学科学院附属第307医院放射科,北京100071

出　　处：《中国医学装备》2015年第10期12-15,共4页China Medical Equipment

基　　金：全军医药卫生科研基金(MS074)"64台(排)螺旋CT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台(排)螺旋CT脑灌注成像联合血管成像对烟雾病研究"

摘　　要：目的：研究成年人缺血型烟雾病（MMD）的CT影像特点，以帮助临床医生选择治疗方案。方法：回顾性分析20例成年人缺血型MMD患者的CT平扫、CT灌注成像及CT血管成像等影像资料，并参考Suzuki 6级血管分级法，对CT血管成像特点进行相应分级（Ⅰ～Ⅵ级）。结果：①CT平扫检出脑内陈旧性梗死灶13例（占65%），急性脑梗死灶1例（占5%），阴性者6例（占30%）；②CT灌注5例（占25%），未发现灌注异常15例（占75%），出现部分脑叶明显低灌注及局限性高灌注；③CT血管成像检出Ⅰ～Ⅵ级分别为1例、2例、5例、6例、4例及2例。结论：成年人缺血型MMD患者脑梗死灶分布以额叶、顶叶皮层或分水岭为主；脑灌注特点表现为正常或血流灌注不均匀，以低灌注为主；血管成像特点以Ⅲ、Ⅳ级为主，属于缺血型MMD中期。Objective： To study the characteristics of CT imaging of adult ischemic type moyamoya disease, involving CT plain scan, CT perfusion imaging （CTP） and CT angiography （CTA）. Methods：A retrospective analysis was made of the imaging data of 20 adult ischemic type moyamoya patients, including CT plain scan, CT perfusion imaging and CT angiography. CT vascular imaging features were graded I-VI with reference to Suzuki vascular grading. Results：Among the 20 patients with adult ischemic type moyamoya , ①CT plain scan： Old infarct lesions occurred in 13 cases（65%）, 1 case suffered from acute cerebral infarction（5%）, and negative patients totalled 6 （30%）;②CT perfusion：5 cases（25%） were normal perfusion, 15 cases（75%） showed obviously low perfusion and local high perfusion;③CT angiography：patients of grade I to VI were respectively 1, 2, 5, 6, 4 and 2. Conclusion：Cerebral infarction lesions associated with adult ischemic type moyamoya disease are distributed mainly in the frontal and parietal cortex, or in watershed regions. Cerebral perfusion is characterized by normal or uneven blood perfusion, especially low perfusion. Vascular imaging manifests mostly degree III and IV, which belong to the middle phase of moyamoya disease.

关 键 词：成年人 缺血型 烟雾病 CT成像 

分 类 号：R816.1[医药卫生—放射医学]