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目的探讨64排螺旋CT血管造影(MSCTA)在烟雾病诊断中的应用价值。方法19例烟雾病患者均行CT平扫和MSCTA检查,在工作站上做容积再现VR)、最大密度投影MIP)和多平面容积重建(MPR)。结果14例脑出血,4例脑梗死,1例大脑发育不良,MSCTA可清晰显示狭窄、闭塞的颈内动脉、颅底异常血管网,其中双侧颈内动脉闭塞12例,单侧颈内动脉闭塞伴同侧大脑后动脉狭窄1例,单侧大脑中动脉闭塞6例,侧支血管表现为相应血管及其分支的粗大、增多、迂曲延长。结论MSCTA可以清晰显示烟雾病血管改变特点,检查方法简单、快捷,VR重建能显示狭窄血管的三维空间关系,较好地显示颅底烟雾状血管,而MIP和MPR在显示细小血管方面较好。CTA是怀疑此病的首选无创筛查方法,为手术治疗提供参考。
Objective To investigate the value of 64-slice spiral CT angiography (MSCTA) in the diagnosis of moyamoya disease. Methods Twenty - nine patients with moyamoya disease underwent CT scan and MSCTA. Volume reproducibility (VR), maximum density projection (MIP) and multiplanar volume reconstruction (MPR) were performed on the workstation. Results 14 cases of cerebral hemorrhage, 4 cases of cerebral infarction, 1 case of cerebral dysplasia, MSCTA can clearly show stenosis, occlusion of the internal carotid artery, skull base abnormal vascular network, including bilateral carotid artery occlusion in 12 cases, unilateral internal carotid artery Occlusion with ipsilateral posterior cerebral artery stenosis in 1 case, unilateral middle cerebral artery occlusion in 6 cases, collateral vessels showed the corresponding vascular and its branches coarse, increased, tortuous extension. Conclusion MSCTA can clearly show the characteristics of vascular changes of moyamoya disease. The examination method is simple and quick. VR reconstruction can show the three-dimensional spatial relationship of stenosed vessels, showing the smoggy blood vessels of the skull base better, while MIP and MPR are better in displaying small blood vessels. CTA is the first choice of noninvasive screening method suspected of the disease, to provide a reference for surgical treatment.