摘要
目的探讨成年人不同类型烟雾病的CT影像特点,以帮助临床医生制定治疗方案。方法回顾性分析48例烟雾病[缺血型烟雾病(缺血型组)18例,出血型烟雾病(出血型组)30例]患者的CT(computed tomography,CT)平扫、CT灌注成像(CT perfusion imaging,CTPI)及CT血管造影(CT angiography,CTA)影像资料,采用Suzuki血管分级法对2组进行CTA分级(Ⅰ—Ⅵ级)。结果 CT平扫显示缺血型组表现脑皮层、分水岭及基底节区脑回样、斑片状低密度影;出血型组表现为基底节区、脑室内及脑沟裂池内斑片状、铸形及脑沟样高密度影。缺血型组早期、中期、晚期烟雾病和脑皮层、分水岭、基底节区、脑室内、蛛网膜下腔脑卒中部位所占比例与出血型组比较差异均有统计学意义(均P<0.05);CTPI为正常、低、高及CTA分级为Ⅰ—Ⅵ级所占比例与出血型组比较差异均有统计学意义(均P<0.05)。结论成人烟雾病以出血型为主,且脑卒中部位以脑室及基底节区为主;成人缺血型烟雾病CTP以低灌注为主,成人出血型烟雾病CTP以灌注正常为主;成人烟雾病CTA血管分级以Ⅱ级、Ⅲ级和Ⅳ级为主。
Objective To discuss the CT imaging characteristics of different types of adult moyamoya disease（MD）,and to help clinicians to formulate the proper therapeutic schedules.Methods A total of 48 patients with ischemic MD（18cases）or hemorrhagic MD（30cases）were recruited into the study.Imaging data of plain CT,CT perfusion imaging（CTPI）and CT angiography（CTA）were analyzed retrospectively.CTA findings were graded Ⅰ-Ⅵ according to Suzuki vascular grading.Results Plain CT showed gyrus-like and patchy hypodense lesions in the cortex,watershed and basal ganglia regions in ischemic MD group,and patchy,casting shape and groove hyperdense lesions in basal ganglia,cerebral ventricle and cistern in hemorrhagic MD.There were significant differences between the two groups in the proportions of patients with early,middle and late stages of MD and patients with lesions in the cortex,watershed,basal ganglia,cerebral ventricle and subarachnoid space,as well as in the proportions of normal perfusion,hypoperfusion and hyperperfusion and CTA Ⅰ-Ⅵ grades（P〈0.05）.Conclusion Hemorrhagic MD is dominant in adults with MD and stroke mainly occurs in cerebral ventricle and basal ganglia.Ischemic MD and hemorrhagic MD mainly show hypoperfusion and normal perfusion on CTP in adults,respectively.In addition,adult MD is characterized by gradeⅡ,Ⅲ orⅣ on CTA.
出处
《南昌大学学报（医学版）》
CAS
2016年第6期33-35,49,共4页
Journal of Nanchang University：Medical Sciences
基金
全军医药卫生科研基金(MS074)
江西省卫生计生委科技计划项目(20142083)
