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目的 探讨烟雾病患者脑血管造影特征。方法 脑血管造影证实84例烟雾病患者,其中男38例,女46例,年龄为5-48岁;临床上有脑缺血症状者40例(48％),出血症状者44例(52％);成人组(≥14岁)58例,年龄为14-48岁,平均(27±13)岁;儿童组26例,年龄为5~12岁,平均(9±2)岁。回顾性分析全脑血管造影的影像改变。结果 77例为双侧颈内动脉床突上段狭窄-闭塞性病变,84例均可见脑底异常血管网形成,69例双侧后交通动脉增粗,77例皮层侧支开放,成人组48例、儿童组8例颈外动脉系统向颅内代偿,78例脑循环时间延长,63例为Suzuki和Takaku分级第四、五、六阶段。 结论 (1)双侧颈内动脉床突上段及大脑前动脉、大脑中动脉近段狭窄或闭塞,部分病例后循环受累;(2)脑底异常血管网形成,8例成人患者存在动脉瘤;(3)广泛的侧支循环建立,以成人组侧支代偿较好;(4)循环时间延长,部分病例颅后窝静脉早期显现。
Objective To explore the characteristics of cerebral angiography in patients with moyamoya disease. Methods Cerebral angiography confirmed 84 patients with moyamoya disease, including 38 males and 46 females, aged from 5-48 years old. There were 40 cases (48%) with clinical symptoms of cerebral ischemia, 44 cases (52% ). In the adult group (≥14 years), 58 cases were aged 14-48 years with an average of (27 ± 13) years. There were 26 children aged 5-12 years (mean, 9 ± 2 years). Retrospective analysis of cerebral angiography image changes. Results Seventy - seven cases were stenosis - occlusive lesions in the superior segment of bilateral internal carotid artery. All of the 84 cases showed abnormal cerebral vascular network, 69 cases of bilateral posterior communicating artery thickening, 77 cases of cortex collateral opening, 48 cases in the adult group In the children group, the external carotid system was compensated to the intracranial system in 8 cases and the cerebral circulation time in 78 cases was prolonged. 63 cases were classified as the fourth, fifth and sixth stage by Suzuki and Takaku. Conclusions (1) The upper carina of bilateral internal carotid artery is stenosed or occluded in the proximal segment of the anterior segment of the anterior cerebral artery and the anterior cerebral artery. In some cases, the circulation is impaired. (2) The anomalous network of the brain is formed. There are aneurysms in 8 adult patients. (3) a wide range of collateral circulation to the adult group collateral compensation better; (4) cycle time, some cases of early posterior fossa veins appear.