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目的探讨螺旋CT三维血管造影作为儿童烟雾病首选诊断方法的临床价值。方法对12例疑烟雾病患儿行螺旋CT血管造影,采集原始数据传至SGI O2图像后处理工作站,采用三种重建方法:最大强度投影(MIP)、表面阴影显示法(SSD)、多平面重建(MPR)。扫描速度0．5s/每转,层厚1mm,用高压注射器肘静脉注射优维显1．0～2．0ml/kg,注射速度2．0～2．5ml/s．扫描延迟时间10～16s,自下向上扫描,所得结果与数字减影脑血管造影(DSA)比较。结果12例烟雾病螺旋CT脑血管造影图像处理中,显示脑梗塞10例、脑出血2例、局限性脑萎缩2例。全部病例均表现为颈内动脉或其分支不同程度的狭窄或闭塞并伴颅内异常血管网,与DSA所见一致。结论螺旋CT三维血管造影诊断儿童烟雾病敏感性高,无创伤,易为患儿及家属接受,可作为儿童烟雾病的首选诊断方法。
Objective To investigate the clinical value of spiral CT three-dimensional angiography as the first choice of diagnosis of moyamoya disease in children. Methods Twelve patients with suspected moyamoya disease underwent spiral CT angiography. The raw data were collected and transmitted to the SGI O2 image post-processing workstation. Three reconstruction methods were used: maximum intensity projection (MIP), surface shadow display (SSD), multiplanar Reconstruction (MPR). Scanning speed of 0.5s / per revolution, layer thickness 1mm, with high pressure syringe elbow venous injection significantly 1.0 ~ 2.0ml / kg, injection speed 2.0 ~ 2.5ml / s. Scanning latency was 10 ~ 16s, scanning from bottom to top, and the results were compared with digital subtraction angiography (DSA). Results In 12 cases of moyamoya disease, 10 cases of cerebral infarction, 2 cases of cerebral hemorrhage and 2 cases of localized cerebral atrophy were shown. All cases were manifested as varying degrees of stenosis or occlusion of the internal carotid artery or its branches with intracranial abnormal vascular network, consistent with DSA. Conclusion Spiral CT three-dimensional angiography in children with high risk of moyamoya disease, non-invasive, easy to accept for children and their families, can be used as the first choice for children with moyamoya diagnostic methods.