本文選題：腦底異常血管網(wǎng)病　切入點：顱內動脈硬化　出處：《中國醫(yī)學影像學雜志》2016年02期

【摘要】：目的腦動脈粥樣硬化(ICAD)和煙霧病(MMD)是大腦中動脈閉塞的常見病因,盡管兩者血管壁有不同的病理變化,但某些情況下常規(guī)血管成像鑒別ICAD和MMD仍較困難,本研究比較高分辨率血管壁MRI(HR-MRI)對MMD與ICAD血管壁成像的結果,探討HR-MRI對MMD與ICAD的鑒別診斷價值。資料與方法42例MMD及107例ICAD患者行HR-MRI檢查,比較兩組大腦中動脈(MCA)狹窄段血管壁外徑及外緣面積、狹窄類型(偏心或向心性)、管壁信號強度(均勻或不均勻)及狹窄段周圍側支血管,兩組血管外徑及面積比較采用受試者操作特征(ROC)曲線分析。結果 MMD組MCA狹窄段血管壁外徑及外緣面積[(1.77±0.42)mm、(2.71±1.62)mm~2]均小于ICAD組[(3.02±0.31)mm、(7.25±1.49)mm~2],差異均有統(tǒng)計學意義(ROC曲線下面積分別為0.982、0.963,P0.001)。MMD組38例管腔向心性狹窄,ICAD組96例偏心性狹窄;MMD組39例管壁信號一致,ICAD組91例信號不一致;MCA狹窄段周圍側支血管形成在MMD組(88.1%)比ICAD組(9.3%)更常見;兩組差異均有統(tǒng)計學意義(χ~2=87.89、78.60、86.62,P0.001)。結論與ICAD相比,HR-MRI顯示MMD狹窄段管腔外徑更小,向心性狹窄,管壁信號均勻及周圍側支血管增多,在MMD與ICAD的鑒別診斷中有很好的應用價值,為顱內動脈狹窄的病因學診斷提供新思路。
[Abstract]:Objective Cerebral atherosclerosis (ICAD) and moyamoya disease (MMD) are the common causes of middle cerebral artery occlusion (MMD). Although there are different pathological changes in the vascular wall between them, conventional angiography is still difficult to distinguish ICAD from MMD in some cases. The purpose of this study was to evaluate the value of HR-MRI in differential diagnosis of MMD and ICAD by comparing the results of high-resolution MRII-MRI in MMD and ICAD. Materials and methods 42 cases of MMD and 107 cases of ICAD were examined with HR-MRI. The external diameter and area of the stenosis segment, the type of stenosis (eccentric or concentric), the signal intensity (uniform or uneven) and the collateral vessels around the stenosis segment were compared between the two groups. Results the external diameter and area of MCA stenosis in MMD group were lower than that in ICAD group [1.77 鹵0.42 鹵0.42 鹵2.71 鹵1.62)mm~2]. There were significant differences in the area under ROC curve between the two groups (3.02 鹵0.31) and the area under ROC curve was significantly lower than that in ICAD group (P < 0.01). MMD group (n = 38). 96 patients with eccentric stenosis in MMD group (n = 39) had the same signal intensity on the wall of the wall. The formation of collateral vessels around the stenosis segment in MMD group (n = 91) was more common than that in ICAD group (n = 9. 3). The difference between the two groups was statistically significant (蠂 2 / 87.89 / 78.60 / 86.62 / P 0.001). Conclusion compared with ICAD, HR-MRI shows that the diameter of narrow segment of MMD is smaller, concentric stenosis, homogeneous signal of wall and increased of peripheral collateral vessels. It has a good value in differential diagnosis between MMD and ICAD. To provide a new idea for the etiological diagnosis of intracranial artery stenosis.
【作者單位】： 南昌大學第二附屬醫(yī)院磁共振室;
【基金】：江西省自然科學基金項目(20132BAB205018)
【分類號】：R743;R445.2
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本文編號：1690809