烟雾病的临床表现及CT、DSA分析

目的:探讨烟雾病的临床特点、头颅CT及DSA表现。方法:对54例烟雾病患者的临床症状、头颅CT及DSA表现行综合分析。结果:54例患者中,发病前29例曾有不同程度脑缺血症状,25例无明显临床症状和体征;CT显示脑出血患者46例,其中原发性脑室出血21例,颅底及脑叶多发梗塞灶7例,1例CT未见异常;DSA表现所有患者双侧颈内动脉末端及大脑前、中动脉起始端狭窄或闭塞,颅底及基底节区异常增生血管网,颈内、外侧支循环血管建立,脑血管循环时间延长。结论:烟雾病患者一般症状不典型,对于临床反复出现脑缺血症状或CT提示为原发性脑室出血、脑叶或颅底多发梗塞灶之青壮年患者应考虑烟雾病可能,DSA可以确诊烟雾病,同时也可以明确患者病变程度,为后续干预提供一定指导意义。

Analysis of the clinical characteristics and manifestation of CT and DSA of moyamoya disease

Objective:To discuss the clinical characteristics and the manifestation of CT and DSA of moyamoya disease. Methods:Clinical symptoms, CT findings, and angiographic features of 54 patients with moyamoya disease were analyzed.Results:Of 54 cases, 29 patients had undergone different degree of clinical symptoms of cerebral ischemia before they fall ill, no well-definded symptoms were found in other 25 patients. Intracranial hemorrhage and infarction were detected on CT in 46 and 7 cases respectively. Stenosis or occlusion of internal carotid bifurcation or proximal of anterior cerebral artery or middle artery were depicted in all the patients by DSA, and abnormal vascular network at basal area was also seen in all cases. Collateral circulation vessels were found on ICA or ECA, and the time of cerebral blood flow circulation were prolonged.Conclusion:The symptoms of moyamoya disease were atypical. If temporary cerebral ischemia are suffered frequently and primary hemorrhage in ventricle or infarction in basal area or intracranial are detected by CT in young man, moyamoya disease should been suspected. The examination of DSA could not only verify the diagnosis, but also identify the degree of the disease, which would be helpful to the therapy plan.