16排螺旋CT血管造影诊断烟雾病的临床价值探讨

目的 探讨16排螺旋CT血管造影(CTA)对烟雾病的诊断价值.方法 回顾性分析24例烟雾病病例,其中男性10例,女性14例,年龄16～71岁.对病例患者进行颅脑CT平扫及CTA检查,应用容积再现(VR)、多平面重建(MPR)、最大密度投影(MIP)技术进行图像后处理.结果 平扫CT表现为15例患者颅内若干部位呈见出血灶.7例出现梗死灶,8例出现脑萎缩,2例正常.CTA显示18例患者双侧颈内动脉终末段血管闭塞或狭窄,双侧大脑前、中动脉局部或全程显示不清,其走行区及周围见较多细小侧支循环血管影,6例患者单侧颈内动脉狭窄,单侧大脑前及中动脉显示不清.18例见较为典型的颅底动脉环周围纤细、烟雾状迂曲血管,3例烟雾状血管较少显示,3例VR重建血管网显示效果一般,但是,经过调整VR透明值,便得以清楚显示血管网.VR重建技术对于显示病变血管与其周围结构的位置关系效果显著,显示侧支和细小血管效果不如MIP和MPR.结论 通过CTA可较为清晰地显示颅底异常的脑血管网,颅内颈内动脉末端及大脑前、中、后动脉近端有不同程度的狭窄、闭塞的特征.在诊疗烟雾病过程时采用16排螺旋CT血管造影具有很重要的临床价值,同时可为临床诊治和预后评判提供可靠依据.

Clinical value of 16 row spiral CT angiography on moyamoya disease

Objective To investigate the 16 row spirl CT angiography diagnosis value of moyamoya disease. Methods A retrospective analysis of 24 eases of moyamoya disease cases,male 10 cases,female 14 eases,aged 16-71 years old.On a case with brain CT scan,following application of technology,the volumer endering （VR）,multiple planar reconstruction（MPR）,maximum intensity projeetion（MIP）. Results The CT scan was performed for 15 patients with intracranial hemorrhage loci in several parts. Seven cases of cerebral infarction, cerebral atrophy in 8 cases,2 cases were normal. CTA revealed 18 cases of patients with bilateral internal carotid artery stenosis or occlusion of the terminal segment of vascular,bilateral anterior cerebral artery,in partial or full display is not clear.the walking area and around to see that more small collateral vascular shadow,6 patients with uniloateral internal carotid artery stenosis,unilateral middle cerebral artery before and display is not clear. Eigteen cases showed typical basilar artery rings around slender, smoky tortuous vessels, 3 cases of moyamoya-like vessels less,3 patients with VR reconstruction vascular network display ingeneral,but,after the adjustment of VR Ttransparent value,will be clearly demonstrated a vascular network.VR reconstruction technique for vascular lesions and its surrounding structures display position effegt is remarkable, however,in thedisplay of collateral and small blood vessels,its effect is better than M1P and MPR. Conclusion CTA can be more clearly through the skull base abnormal cerebral vascular network,intracranial internal carotid artery and distal anterior cerebral artery after proximal,in different dergree of stenosis,occlusion of the characteristics.In thediagnosis of moyamoya disease process using 16 slice spiral CT angiography has very importmant clinical value,at the same time for clinical diagnosis and prognosis of flat to provide reliable basis.