成人型moya moya病的MR和MRA诊断(附6例分析)

目的：分析成人型moyamoya病的MRI和MRA影像特征。方法：回顾性分析6例经DSA证实的成人moyamoya病的MRI及MRA影像资料，采用GE1.5T超导型MR扫描系统行SE、FSE序旬MRI和三维时间飞跃法MRA。结果：成人型moyamoya病主要表现为多发腔隙性梗塞、脑萎缩，或并发脑实质出血、蛛网膜下腔出血。MRI显示闭塞的颅底大血管流空效应消失，兵脑和基底节区侧支循环流空信号增多，脑实质缺血或出血改变。MRA直接显示狭窄或闭塞的预内动脉（ICA）、大脑中动脉（MCA）、大脑前动脉（ACA）及侧支血管网。与DSA对比，MRA能够准确地显示闭塞或狭窄的大血管和代偿的不成形的弯延扭曲的侧支血管网。结论：MRI和MRA相结合可正确诊断moyamoya病，MRA是一种无创、短时、成功率和准确性高的检查方法，也可用于筛选可疑颅内动脉狭窄或闭塞的患者，避免或减少血管造影的次数。

MRI and MRA diagnosis of moyamoya disease in adult(a report of 6 cases)

Objective:To analyze the MRI and MRA features of moyamoya diseases in adult.Method:MR appearances of 6 patients with moyamoya disease confirmed by DSA were analyzed retrospectively.MRI with SE,FSE sequences and 3D TOF MRA were performed on a GE 1.5T MR unit.Results:Moyamoya disease in adult appeared mostly as cortical cerebral is chemia and/or multiple lacunar infarction,encephalatrophy,and cerebral or subarachnoid hemorrhage.MRI showed no flow void in the occluded cerebral artery,and obvious flow void of extensive anastomotic network in thalamus and basal ganglia region.MRA demonstrated directly the stenosis or occlusion of the bifurcation of ICA,proximal portion of the ACA or MCA,and extensive anastomotic network.In comparison with DSA,MRA could accurately show the stenosis or occlusion of cerebral arteries and tortuous collateral circulation.Conclusion:MRI,together with MRA,is an effective noninvasive method for the diagnosis of moyamoya disease and suitable for screening to replace the procedure of DSA.