高分辨率磁共振在颅底烟雾状血管相关疾病中的应用价值

摘要

Objective To explore the value of 3.0 T multiple high resolution MRI sequences in digital subtract angiograph (DSA) or magnetic resonance angiography (MRA), which found that the formation of moyamoya-like collateral vessels at the base of the brain.Methods The patients of this HR MRI research came from Qilu hospital of Shandong University ( we finally collect-ed 30 patients), all of these patients were scanned multiple sequences on a 3.0 T MRI, which consisted of routine brain MR se-quences (T1WI, T2WI, FLAIR, DWI), 3D-TOF-MRA and high resolution MRI sequences.The patients were divided into two groups with respect to the related standard:moyamoya disease (MMD) (n=17)and intracranial atherosclerotic disease-moyamoya syndrome (ICAD-MMS) (n=13).Characteristics were compared between the two groups , Which included unilateral or bilateral proximal of middle cerebral arteries were stenosis or occlusion , the type of intracranial lesions ( ischemia or hemorrhage ) and ste-nosis or occlusion of distal of the internal carotid arteries .All statistical analyses were performed with SPSS 17.0.Results 1) The MMD group (mean age 30.9 ±14.4 years) was younger on average than the ICAD-MMS group (mean age), P =0.001. There were no differences in sex between the two groups ( P =0.139);2) The two groups had no signoficance in occlusive or stenosis of unilateral or bilateral MCA ( P =0.242).The incidence of intracerebral hemorrhage in the MMD group was higher than ICAD-MMS group ( P =0.024).Stenosis or occlusion of internal carotid arteries was more common in MMD group ( P =0.007).Statistical significance was defined as a p-value less than 0.05.Conclusion High resolution MRI play an important role in exploring the pathogenesis of the formation of moyamoya-like collateral vessels which uncovered in DSA or MRA , and it provided additional crucial images in the process of the diseases , and has made it possible to diagnose MMD and ICAD-MMS by a noninvasive method .%目的 探讨3.0T多序列高分辨率磁共振对数字减影血管造影(DSA)或磁共振血管成像(MRA)有烟雾状血管形成的疾病的应用价值.方法 收集山东大学齐鲁医院经DSA或MRA证实有烟雾状血管形成的患者(最终收集30例),在3.0T磁共振扫描仪上行常规颅脑平扫(T1WI、T2WI、FLAIR、DWI)、3D-TOF-MRA及高分辨率序列扫描,参照相关标准将患者分为烟雾病(moyamoya disease,MMD)组(n=17)和脑动脉粥样硬化相关-烟雾病综合征(intracranial athero-sclerotic disease-moyamoya syndrome,ICAD-MMS)组(n=13),观察两组患者单侧或双侧大脑中动脉起始段受累、管腔是否闭塞、脑实质病变的类型(缺血或出血)及颈内动脉末端管腔是否受累.采集数据使用SPSS 17.0统计学软件进行分析.结果 1)MMD组患者平均年龄(30.9±14.4)岁,相对于ICAD-MMS组(44.6±3.9)岁,偏小(P=0.001),两组患者性别差异无统计学意义(P=0.139);2)两组疾病单、双侧大脑中动脉受累无统计学意义(P=0.242);3)MMD组脑实质出血发生的几率高于ICAD-MMS组(P=0.024),且MMD组颈内动脉末端管腔易受累(P=0.007).结论 3.0T高分辨率磁共振检查对DSA或MRA有烟雾状血管形成的疾病病因的探讨有重要的价值,并且对疾病病理过程的研究提供了重要的影像学资料,使通过无创性方法诊断MMD及ICAD-MMS成为了可能.