高分辨率血管壁MRI对烟雾病与脑动脉粥样硬化的鉴别诊断

发布时间：2018-03-31 12:49

  本文选题：脑底异常血管网病　切入点：颅内动脉硬化　出处：《中国医学影像学杂志》2016年02期

【摘要】：目的脑动脉粥样硬化(ICAD)和烟雾病(MMD)是大脑中动脉闭塞的常见病因,尽管两者血管壁有不同的病理变化,但某些情况下常规血管成像鉴别ICAD和MMD仍较困难,本研究比较高分辨率血管壁MRI(HR-MRI)对MMD与ICAD血管壁成像的结果,探讨HR-MRI对MMD与ICAD的鉴别诊断价值。资料与方法42例MMD及107例ICAD患者行HR-MRI检查,比较两组大脑中动脉(MCA)狭窄段血管壁外径及外缘面积、狭窄类型(偏心或向心性)、管壁信号强度(均匀或不均匀)及狭窄段周围侧支血管,两组血管外径及面积比较采用受试者操作特征(ROC)曲线分析。结果 MMD组MCA狭窄段血管壁外径及外缘面积[(1.77±0.42)mm、(2.71±1.62)mm~2]均小于ICAD组[(3.02±0.31)mm、(7.25±1.49)mm~2],差异均有统计学意义(ROC曲线下面积分别为0.982、0.963,P0.001)。MMD组38例管腔向心性狭窄,ICAD组96例偏心性狭窄;MMD组39例管壁信号一致,ICAD组91例信号不一致;MCA狭窄段周围侧支血管形成在MMD组(88.1%)比ICAD组(9.3%)更常见;两组差异均有统计学意义(χ~2=87.89、78.60、86.62,P0.001)。结论与ICAD相比,HR-MRI显示MMD狭窄段管腔外径更小,向心性狭窄,管壁信号均匀及周围侧支血管增多,在MMD与ICAD的鉴别诊断中有很好的应用价值,为颅内动脉狭窄的病因学诊断提供新思路。
[Abstract]:Objective Cerebral atherosclerosis (ICAD) and moyamoya disease (MMD) are the common causes of middle cerebral artery occlusion (MMD). Although there are different pathological changes in the vascular wall between them, conventional angiography is still difficult to distinguish ICAD from MMD in some cases. The purpose of this study was to evaluate the value of HR-MRI in differential diagnosis of MMD and ICAD by comparing the results of high-resolution MRII-MRI in MMD and ICAD. Materials and methods 42 cases of MMD and 107 cases of ICAD were examined with HR-MRI. The external diameter and area of the stenosis segment, the type of stenosis (eccentric or concentric), the signal intensity (uniform or uneven) and the collateral vessels around the stenosis segment were compared between the two groups. Results the external diameter and area of MCA stenosis in MMD group were lower than that in ICAD group [1.77 卤0.42 卤0.42 卤2.71 卤1.62)mm~2]. There were significant differences in the area under ROC curve between the two groups (3.02 卤0.31) and the area under ROC curve was significantly lower than that in ICAD group (P < 0.01). MMD group (n = 38). 96 patients with eccentric stenosis in MMD group (n = 39) had the same signal intensity on the wall of the wall. The formation of collateral vessels around the stenosis segment in MMD group (n = 91) was more common than that in ICAD group (n = 9. 3). The difference between the two groups was statistically significant (蠂 2 / 87.89 / 78.60 / 86.62 / P 0.001). Conclusion compared with ICAD, HR-MRI shows that the diameter of narrow segment of MMD is smaller, concentric stenosis, homogeneous signal of wall and increased of peripheral collateral vessels. It has a good value in differential diagnosis between MMD and ICAD. To provide a new idea for the etiological diagnosis of intracranial artery stenosis.
【作者单位】： 南昌大学第二附属医院磁共振室;
【基金】：江西省自然科学基金项目(20132BAB205018)
【分类号】：R743;R445.2
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本文编号：1690809