摘要
目的研究烟雾病的临床特点、影像表现及两者之间的关系。方法回顾分析首都医科大学附属北京天坛医院神经内科收治的113例经数字减影血管造影(DSA)和磁共振血管造影(MRA)确诊的烟雾病患者,分为青少年组(<20岁)和成人组(≥20岁),分析其临床表现,CT、MRI、DSA等影像学检测结果以及2组之间的差异。结果本组烟雾病患者的发病年龄有2个高峰:9～12岁和35～39岁。青少年组31例,其中缺血性卒中15例(48.4%),出血性卒中8例(25.8%),癫痫发作5例(16.1%),反复头痛3例(9.7%)。成人组82例,其中出血性卒中41例(50%),缺血性卒中36例(43.9%),反复头痛发作4例(4.9%),癫痫发作1例(1.2%)。DSA和MRA均表现为双侧病变,均可见到烟雾状异常血管网。青少年组以双侧颈内动脉狭窄、大脑中动脉和大脑前动脉闭塞为主,与成人组相比差异有统计学意义(P<0.05),其余脑血管病变在2组间差异无统计学意义。结论成人组发病高于青少年组。有2个发病的高峰年龄(9～12岁,35～39岁),青少年组以缺血性卒中为主,成人组以出血性卒中为主。DSA是烟雾病诊断的金标准。MRA以其无创、方便等优势,成为本病筛查、诊断、随访的首选检查方法。
Objective To investigate the clinical characteristics, imagery display and their correlation with moyamoya disease （MMD）. Methods We summarized retrospectively a total of 113 cases with moyamoya disease, who hospitalized, and diagnosed by digital subtraction angiography（DSA） and magnetic resonance angiography（MRA） in Beijing Tiantan Hospital. All subjects were divided into teenager group （ 〈 20 years old, total 31 cases） and adult group （ ≥20 years old, total 82 cases）. Results Onset age of patients with moyamoya disease present two peaks in present study, 10 - 14 and 35 - 39 years old respectively. Among 31 subjects in teenager group, there were 15 subjects with ischemic stroke（48.4% ）, which was dominant, 8 subjects with hemorrhagic stroke（25.8% ）, 5 subjects with epileptic seizure repeatedly（ 16.1% ）. Among 82 subjects in adult group, there were 41 subjects with hemorrhagic stroke（50% ） , 36 subjects with ischemic stroke（43.9% ）. Both DSA and MRA displayed bilateral lesions, in which we could find abnormal vascular networks just like smog. In teenager group, occlusions of bilateral middle cerebral artery （64.5 % ） and anterior cerebral artery （61. 3% ） were dominant. In adult group, occlusions of bilateral internal carotid artery（45.1% ）and middle cerebral artery（46.3% ）were dominant. In addition, there were 5 cases with occlusions of posterior cerebral artery and one case with vertebral artery stenosis, Conclusion Morbidity in adult group was higher than in teenager group, lschemie stroke often occured in children with MMD, while hemorrhagic stroke often occured in adult group. DSA is diagnostic golden standard for MMD, which could accurately display site and degree of injured blood vessel. MRA is being applied more and more extensively to clinical because of its superiority, including non-invasive, non- radioactivity and no demand contrast medium, and so on . In addition, MRA also could reflect the condition on brain parenchyma and intracranial blood vessel from both morphology and function, which was first selected examination means for screening, diagnosis and follow-up of MMD. Furthermore, some scholars think that transcranial doppler（TCD） could be one of method to screen stenosis and occlusion of cerebral arteries, which could detect patients with moyamoya disease in earlier period and apply to follow-up.
出处
《首都医科大学学报》
CAS
2008年第4期508-511,共4页
Journal of Capital Medical University
关键词
烟雾病
数字减影血管造影
磁共振血管造影
moyamoya disease
digital subtraction angiography
magnetic resonance angiography
