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目的:评价双源CT全脑灌注成像(CT perfusion,CTP)联合CT血管成像(CT angiography,CTA)在烟雾病(Moyamoya disease,MMD)患者中的应用价值。材料与方法:回顾性分析经临床或CTA成像确诊11例烟雾病患者的CT平扫、CTP及CTA数据。以11名CTP正常患者的灌注值作为参考值。将10例烟雾病患者分为无临床症状组和脑卒中组,分析其临床症状、灌注参数值及侧枝循环情况。结果:无临床症状组:前、后交通动脉,双侧眼动脉、颞浅动脉、枕动脉增粗血管明显增多,增粗的血管支数占正常支数的百分比分别为35%、80%、80%、50%、65%。双侧脑组织CBF、CBV接近正常,MTT、TTP正常或稍有延长。脑卒中组:增粗血管较少,前、后交通动脉,双侧眼动脉、颞浅动脉、枕动脉增粗的血管支数占正常支数的百分比分别为15%、35%、35%、40%、40%,病变侧CBF、CBV显著降低,TTP、MTT延长。结论:双源CT全脑灌注成像联合CTA可用于评价烟雾病患者的脑部血管形态、血容量变化及侧支循环情况,其临床症状与侧枝循环密切相关。
Objective: To evaluate the value of dual CT CT perfusion (CTP) and CT angiography (CTA) in patients with Moyamoya disease (MMD). Materials and Methods: CT scan, CTP and CTA data of 11 patients with moyamoya disease confirmed by clinical or CTA imaging were retrospectively analyzed. The perfusion values of 11 normal CTP patients were used as reference values. Ten patients with moyamoya disease were divided into no symptom group and stroke group, and their clinical symptoms, perfusion parameters and collateral circulation were analyzed. Results: In the group without clinical symptoms, the thickening blood vessels of the communicating artery, bilateral ophthalmic artery, superficial temporal artery and occipital artery were significantly increased in the anterior and posterior groups. The percentage of thickening vascular branches in the normal branches were 35% and 80% 80%, 50%, 65%. Bilateral brain tissue CBF, CBV close to normal, MTT, TTP normal or slightly prolonged. Stroke group: less thickened blood vessels, 15%, 35%, 35%, respectively, of normal vessels in frontal and posterior communicating artery, bilateral ophthalmic artery, superficial temporal artery and occipital artery, 40%, 40%, CBF lesion side, CBV significantly reduced, TTP, MTT prolonged. Conclusion: Dual-source CT whole brain perfusion imaging combined with CTA can be used to evaluate the changes of blood vessel morphology, blood volume and collateral circulation in patients with moyamoya disease. The clinical symptoms are closely related to collateral circulation.