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目的探讨烟雾病的磁共振血管成像(MRA)和全脑数字减影血管造影(DSA)的特征。方法回顾性分析16例烟雾病患者的MRA和DSA资料。结果 16例均为成年人,发病年龄平均40.5岁,以缺血性脑卒中为主,临床表现为偏瘫6例,双侧肢体交替性无力4例,阵发性或持续性头痛3例,阵发性或持续性头晕2例,记忆力减低1例,言语不清3例。头颅MRI显示:脑出血4例,脑梗死9例,3例未见异常。MRA和(或)DSA显示两种检查所见颈内动脉、大脑中动脉、大脑前动脉病变基本一致,均能发现烟雾状血管网。烟雾病的病变血管与临床表现不完全一致。结论对年轻无脑血管危险因素的反复短暂性脑缺血发作或脑卒中患者,反复头痛、头晕者,应予MRA检查,必要时DSA检查,以早期诊断烟雾病,从而指导临床作出合理的治疗。
Objective To explore the features of magnetic resonance angiography (MRA) and total digital subtraction angiography (DSA) of moyamoya disease. Methods The MRA and DSA data of 16 patients with moyamoya disease were retrospectively analyzed. Results All 16 cases were adults, with an average age of onset of 40.5 years. The main clinical manifestations were ischemic stroke. Six cases were hemiparesis, four cases were bilateral alternation and weakness, and three cases were paroxysmal or persistent headache. 2 cases of paroxysmal or persistent dizziness, 1 case of memory loss, 3 cases of unclear speech. Head MRI showed: 4 cases of cerebral hemorrhage, cerebral infarction in 9 cases, 3 cases showed no abnormalities. MRA and / or DSA showed that the internal carotid artery, the middle cerebral artery and the anterior cerebral artery in the two examinations showed basically the same pathological changes, and the smokey vascular network could be found. Moyamoya disease vascular lesions and clinical manifestations are not exactly the same. Conclusions For young patients with recurrent transient ischemic stroke or stroke without cerebral vascular risk factors, MRA should be performed if there are repeated headache and dizziness. If necessary, DSA should be performed to diagnose moyamoya disease in the early stage to guide the clinical treatment .