25例烟雾病的临床特点及影像学分析

发布时间：2018-05-05 08:46

本文选题：烟雾病 + 临床表现　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：分析烟雾病的临床特点及影像学表现，探讨各种辅助检查对该病的诊断价值。方法：回顾性研究我院神经内科2012年8月至2013年12月收治的烟雾病患者，，共25例，对患者性别、发病的年龄、临床表现、影像学分析、治疗及预后等多方面进行分析。结果： 1、本组患者共25例，年龄从21岁到59岁，平均年龄43岁，发病年龄高峰期在41-45岁，男性13例，女性12例。 2、本组病例中，25名患者发病前均无明显诱因，临床表现各异。其中缺血性脑血管病19例，出血性脑血管病6例，其中脑梗死12例，短暂性脑缺血发作7例，脑叶出血3例，脑室出血2例，蛛网膜下腔出血1例。 3、本组25名患者均行DSA检查，双侧颈内动脉末端狭窄2例，闭塞6例，双侧大脑中动脉闭塞4例，一侧大脑前动脉、对侧大脑中动脉狭窄或闭塞3例，单侧大脑中狭窄4例，单侧大脑中闭塞5例，同侧大脑中动脉、大脑前动脉狭窄1例，3例合并动脉瘤。 4、25例患者均现行TCD检查，发现血管狭窄或闭塞可能后行DSA检查确诊为烟雾病。结论： 1、成人烟雾病的发病高峰为41-45岁左右。 2、成人烟雾病患者中缺血型患者比例较前明显增高。 3、缺血型烟雾病DSA分期以第3期为主，而出血型烟雾病DSA分期以第4、5期为主。 4、出血型烟雾病患者血管增生明显，常合并动脉瘤。 5、TCD对于烟雾病的诊断有一定特异性，其中对第3、4期患者的检出率更高，对DSA结果有意义，因此TCD可以广泛用于烟雾病的筛查。
[Abstract]:Objective: To analyze the clinical features and imaging manifestations of moyamoya disease and to explore the diagnostic value of various auxiliary examinations for moyamoya disease. Methods: A retrospective study of 25 patients with moyamoya disease from August 2012 to December 2013 was conducted. The sex, age of onset, clinical manifestation, imaging analysis, treatment and prognosis of moyamoya disease were analyzed. Results: 1. There were 25 patients, aged from 21 to 59 years, with an average age of 43 years. The peak age of onset was 41-45 years, 13 males and 12 females. 2. There were no obvious inducements and different clinical manifestations in 25 patients. There were 19 cases of ischemic cerebrovascular disease and 6 cases of hemorrhagic cerebrovascular disease, including 12 cases of cerebral infarction, 7 cases of transient ischemic attack, 3 cases of lobar hemorrhage, 2 cases of ventricular hemorrhage and 1 case of subarachnoid hemorrhage. 3. DSA examination was performed in all 25 patients, including bilateral internal carotid artery stenosis in 2 cases, occlusion in 6 cases, bilateral middle cerebral artery occlusion in 4 cases, unilateral anterior cerebral artery in 3 cases, contralateral middle cerebral artery stenosis or occlusion in 3 cases, unilateral middle cerebral artery stenosis in 4 cases. Unilateral middle cerebral occlusion in 5 cases, ipsilateral middle cerebral artery in 1 case, anterior cerebral artery stenosis in 1 case with aneurysm. 4 all 25 patients were diagnosed as moyamoya disease by DSA. Conclusion: 1. The peak of adult moyamoya disease is about 41-45 years old. 2. The proportion of ischemic patients in adult moyamoya disease was significantly higher than that before. 3. The DSA stage of ischemic moyamoya disease was mainly in the third stage, while the DSA stage of blood type moyamoya disease was stage 4 or 5. 4, the blood group moyamoya disease patient blood vessel proliferation is obvious, often complicates the aneurysm. 5TCD has a certain specificity for the diagnosis of moyamoya disease, among which the detection rate of stage 3 / 4 is higher, and it is significant to the result of DSA. Therefore, TCD can be widely used for screening of moyamoya disease.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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