高分辨率磁共振在颅底烟雾状血管相关疾病中的应用价值  

Value of high resolution MRI in the formation of moyamoya-like collateral vessels related disease at the base of the brain

作　　者：杜佳晨 赵鹏[3] 王龙[2] 李福艳[1] 李红霞[1] 崔谊[1] 张玫[2] 

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012 [2]泰山医学院研究生部,山东泰安271000 [3]山东大学齐鲁医院神经外科,山东济南250012

出　　处：《医学影像学杂志》2017年第2期195-198,共4页Journal of Medical Imaging

基　　金：山东省科技发展计划项目(编号:2014GSF118102)

摘　　要：目的探讨3.0T多序列高分辨率磁共振对数字减影血管造影(DSA)或磁共振血管成像(MRA)有烟雾状血管形成的疾病的应用价值。方法收集山东大学齐鲁医院经DSA或MRA证实有烟雾状血管形成的患者(最终收集30例),在3.0T磁共振扫描仪上行常规颅脑平扫(T_1WI、T_2WI、FLAIR、DWI)、3D-TOF-MRA及高分辨率序列扫描,参照相关标准将患者分为烟雾病(moyamoya disease,MMD)组(n=17)和脑动脉粥样硬化相关-烟雾病综合征(intracranial atherosclerotic disease-moyamoya syndrome,ICAD-MMS)组(n=13),观察两组患者单侧或双侧大脑中动脉起始段受累、管腔是否闭塞、脑实质病变的类型(缺血或出血)及颈内动脉末端管腔是否受累。采集数据使用SPSS 17.0统计学软件进行分析。结果 1)MMD组患者平均年龄(30.9±14.4)岁,相对于ICAD-MMS组(44.6±3.9)岁,偏小(P=0.001),两组患者性别差异无统计学意义(P=0.139);2)两组疾病单、双侧大脑中动脉受累无统计学意义(P=0.242);3)MMD组脑实质出血发生的几率高于ICAD-MMS组(P=0.024),且MMD组颈内动脉末端管腔易受累(P=0.007)。结论 3.0T高分辨率磁共振检查对DSA或MRA有烟雾状血管形成的疾病病因的探讨有重要的价值,并且对疾病病理过程的研究提供了重要的影像学资料,使通过无创性方法诊断MMD及ICAD-MMS成为了可能。Objective To explore the value of 3.0 T multiple high resolution MRI sequences in digital subtract angiograph （DSA） or magnetic resonance angiography （MRA）, which found that the formation of moyamoya-like collateral vessels at the base of the brain. Methods The patients of this HR MRI research came from Qilu hospital of Shandong University （ we finally collect- ed 30 patients）, all of these patients were scanned multiple sequences on a 3.0 T MRI, which consisted of routine brain MR se- quences （T1WI, T2WI, FLAIR, DWI）, 3D-TOF-MRA and high resolution MRI sequences. The patients were divided into two groups with respect to the related standard ： moyamoya disease （MMD） （ n = 17 ） and intracranial atherosclerotic disease-moyamoya syndrome （ICAD-MMS） （n = 13 ）. Characteristics were compared between the two groups, Which included unilateral or bilateral proximal of middle cerebral arteries were stenosis or occlusion, the type of intracranial lesions （isehemia or hemorrhage） and ste- nosis or occlusion of distal of the internal carotid arteries. All statistical analyses were performed with SPSS 17.0. Results 1 ） The MMD group （ mean age 30.9 ± 14.4 years） was younger on average than the ICAD-MMS group （ mean age） , P = 0. 001. There were no differences in sex between the two groups （ P =0. 139） ; 2） The two groups had no signoficance in occlusive or stenosis of unilateral or bilateral MCA （ P = 0. 242）. The incidence of intracerebral hemorrhage in the MMD group was higher than ICAD-MMS group （ P = 0. 024）. Stenosis or occlusion of internal carotid arteries was more common in MMD group （ P = 0. 007）. Statistical significance was defined as a p-value less than 0.05. Conclusion High resolution MRI play an important role in exploring the pathogenesis of the formation of moyamoya-like collateral vessels which uncovered in DSA or MRA, and it provided additional crucial images in the process of the diseases, and has made it possible to diagnose MMD and ICAD-MMS

关 键 词：磁共振成像 烟雾病 脑动脉粥样硬化 烟雾病综合征 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.1[医药卫生—诊断学]