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目的探讨烟雾病MRI、MRA的诊断特征。方法回顾分析17例10～49岁烟雾病患者的MRI和MRA表现。MRI至少包括横断面T1WI、T2WI;4例行增强T1WI,2例行增强MRA,5例行快速自旋回波液体衰减反转恢复(FLAIR)检查;16例行MRA,采用三维时间飞跃法(3DTOF)。结果MRI可显示颈内动脉(ICA)末段、大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)血管流空影纤细或缺失(17/17);脑实质内或脑池内代偿扩张的烟雾血管(17/17);脑梗死5例、陈旧性出血灶4例,单侧侧脑室扩张2例。MRA对血管狭窄或闭塞范围、程度显示更直观,且能显示颈外动脉分支、大脑后动脉分支侧枝循环。2例显示常春藤征(ivysign)和柔脑膜高信号征。结论MRI可提示烟雾病诊断,结合MRA可明确诊断。
Objective To explore the diagnostic features of moyamoya disease MRI and MRA. Methods The MRI and MRA findings of 17 patients with moyamoya disease from 10 to 49 years were retrospectively analyzed. MRI included at least T1WI and T2WI; 4 routinely enhanced T1WI, 2 routine enhanced MRA and 5 fast FLAIR; 16 MRA with 3D TOF ). Results MRI showed stenosis or absence of blood flow in the distal segment of ICA, ACA, MCA and PCA; Cerebral pool compensatory expansion of the smoke and blood vessels (17/17); cerebral infarction in 5 cases, 4 cases of old hemorrhagic lesions, unilateral ventricular dilatation in 2 cases. MRA vascular stenosis or occlusion range, the degree showed more intuitive, and can show branches of the external carotid artery, posterior cerebral artery branch collateral circulation. Two cases showed signs of ivysign and meningeal hyperintensities. Conclusion MRI can prompt the diagnosis of moyamoya disease, combined with MRA can confirm the diagnosis.