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目的评价烟雾病的诊断方法,讨论其鉴别诊断。方法回顾性分析11例烟雾病的CT、M RI及M RA资料,分析脑实质及脑血管的形态学改变。结果C T及M R I表现为脑实质改变:脑出血3例,脑梗死6例,脑萎缩2例;M RA均见有不同程度的颈内动脉分叉以上狭窄或闭塞,其中双侧颈内动脉狭窄6例,单侧颈内动脉狭窄5例;大脑中动脉狭窄20支,大脑前动脉狭窄18支,大脑后动脉狭窄14支;9例同时显示异常血管网。结论烟雾病主要靠放射学诊断,M RA可很好地显示烟雾病异常血管,可作为筛查烟雾病首选方法。诊断时,要排除脑中风、动脉瘤和动静脉畸形出血。
Objective To evaluate the diagnosis of moyamoya disease and discuss its differential diagnosis. Methods The CT, M RI and M RA data of 11 cases of moyamoya disease were retrospectively analyzed. The morphological changes of brain parenchyma and cerebrovascular were analyzed. Results CT and MRI showed cerebral parenchymal changes: 3 cases of intracerebral hemorrhage, 6 cases of cerebral infarction and 2 cases of brain atrophy. There were different degrees of stenosis or occlusion of carotid bifurcation in M RA, of which bilateral internal carotid artery stenosis 6 cases, 5 cases of unilateral carotid artery stenosis; 20 cases of middle cerebral artery stenosis, 18 cases of anterior cerebral artery stenosis and 14 cases of posterior cerebral artery stenosis; 9 cases showed abnormal vascular network at the same time. Conclusion Moyamoya disease mainly relies on radiological diagnosis. M RA can display abnormal moyamoya disease well and can be used as the preferred method of screening moyamoya disease. Diagnosis, to rule out stroke, aneurysm and arteriovenous malformations bleeding.