64排螺旋CT减影血管成像在头部烟雾病诊断中的应用

目的探讨64排螺旋CT减影血管成像技术在烟雾病诊断中的临床价值。方法回顾分析在我院行减影脑血管成像烟雾病患者,共18例。对整个头部平扫、增强动脉早期和静脉早期扫描获得未减影数据,将动脉早期数据减去平扫数据获得减影动脉期数据,静脉早期数据减去动脉早期数据获得减影静脉期数据。采用容积再现(VR)、最大密度投影(MIP)重建减影血管图像。结果减影图像去除了动脉、静脉相互的及颅骨的干扰,对脑动、静脉解剖结构显示清楚,特别是对烟雾病异常颈内动脉和脑底血管网显示。本组显示脑底异常血管网占100%;双侧颈内动脉狭窄占61%,左侧颈内动脉狭窄占17%,右侧颈内动脉狭窄占22%;双侧大脑中动脉狭窄占39%(其中1例左侧大脑中动脉闭塞),右侧大脑中动脉狭窄占17%;双侧大脑前动脉狭窄占39%(其中1例双侧大脑前动脉闭塞),无单侧大脑前动脉狭窄;合并脑动脉瘤占17%;全部脑静脉未见异常。结论 64排螺旋CT智能跟踪扫描减影技术能清楚分别显示脑动脉和脑静脉,在显示颅内动脉血管畸形时可排除脑静脉畸形,对颅内烟雾病分析评价有较大临床价值。

The application of moyamoya with 64-rows helical CT subtraction angiography

Abstract] Objective To investigate the clinical diagnostic value of moyamoya with 64-rows helical CT subtraction angiography. Methods Retrospective moyamoya of 18 cases with 64-rows helical CT double phase subtraction angiography. All eases were performed unenhanced earl arterial and early venous phase enhanced scanning to acquisite nosubtracted data. Used data of early arterial phase subtract unenhanced data to acquisite cerebral arterial data, early venous phase enhanced data subtract early arterial phase enhanced data to acquisite subtracted cerebral venous data.Volume rendering （VR）, maximum intensity projection （MIP） were used to reconstruct vessels. Results Subtracted images were removed the mutual interference between artery and vein, removed the interference of bone in the same time, anatomical structure of brain arteriovenous showed clearly. Especially for abnormal moyamoya internal carotid artery and pavimentum eerebri vasoganglion. This showed that anomaly pavimentum cerebri vasoganglion accounted for 100%; Bilateral internal carotid artery stenosis accounted for 61%, the left internal carotid artery stenosis accounted for 17%, and the right internal carotid artery stenosis accounted for 22%. Bilateral MCA stenosis accounted for 39% （1 left middle cerebral artery occlusion）, the fight middle cerebral artery]（MCA） stenosis accounted for 17%. Double side anterior cerebral artery（ACA） stenasis accounted for 39% （1 bilateral ACA occlusion）; complicating cerebral aneurysms 17%. All cerebral venous has no abnormality be seen. Conclusion 64-rows helical CT scan subtraction intelligent tracing technology can separately clear showed that cerebral artery and cerebral venous, intraeranial vascular abnormalities in display can exclude cerebral venous malformation, analysis and evaluation of intracranial moyamoya has great clinical value.