烟雾病侧支循环MRA与DSA表现及诊断价值

目的分析烟雾病(MMD)侧支循环的MRA及DSA表现,比较其诊断价值。方法回顾分析了18例MRA和11例DSA烟雾病患者的侧支循环形成的MRA表现,并比较9例同时行MRA和DSA检查患者侧支血管显示情况。结果 18例MRA和11例DSA均显示颈内动脉终末段及大脑前、中动脉的不规则狭窄,均显示眼动脉、脑膜中动脉、颞浅动脉的增粗、迂曲,2例DSA上显示丘脑穿支及后胼周动脉增粗、扩张,9例同时行MRA和DSA检查的各侧支眼动脉、脑膜中动脉、颞浅动脉、丘脑穿支及后胼周动脉显示分别为4例、6例、5例、0例和7例、9例、9例、2例。结论 DSA显示侧支循环细节优于MRA,MRA能粗略的显示侧支循环的形成,作为无创性检查对于临床筛选烟雾病为首选方法。

Value of MRA and DSA in Moyamoya disease

Objective To compare the value of MRA and DSA in demonstrating the collateral circulation in Moyamoya disease. Methods MRA of 18 patients and DSA of 11 patients with Moyamoya disease were retrospectively analyzed. Both MRA and DSA were performed in 9 patients. The delineation of collateral circulation by both imaging modalities was compared. Results Irregular stenosis of the distal internal carotid, anterior and middle cerebral arteries as well as dilatation and tortuosity of the ophthalmic, middle meningeal and superficial temporal arteries were shown in all patients by MRA and DSA. DSA showed large thalamic perforating and posterior pericallosal arteries in two patients. In 9 patients, the collateral circulation including ophthalmic artery （4, 7）, middle meningeal artery （6, 9）, superficial temporal artery （5, 9）, posterior thalamic perforating branches and posterior pericallosal artery （0, 2） was demonstrated on MRA and DSA respectively. Conclu- sion DSA displays the collateral circulation better than MRA. While MRA is the initial non-invasive examination to detect Moyamoya disease, DSA is necessary for patients who require surgery.