Moyamoya病的MRI和MRA表现:儿童与成人患者的比较

目的　总结Moyamoya病患者的MRI和MRA表现。方法　分析 10例Moyamoya病患者 ( 6例儿童 ,4例成人 )的MRI和MRA表现。MRA影像主要研究颈内动脉和大脑中动脉的狭窄以及侧支血管的出现情况 ,并由此进行分期 ;MRI影像主要研究脑梗塞的发生部位。并分别对儿童和成人的MRA和MRI表现进行比较。结果　儿童和成人患者的MRA表现均为颈内动脉、大脑中动脉狭窄 ,伴侧支血管形成。而MRI表现两组有较明显的差别 ,儿童患者以大脑半球皮质和 /或皮质下梗塞为主 ,达 75 % ( 9/12 ) ,成人患者以大脑半球半卵圆中心脑白质和基底节区腔隙性梗塞为主 ,达 87.5 % ( 7/8)。结论　MRI和MRA是评价Moyamoya病的一种很好的影像学方法。儿童与成人Moyamoya病的MRI表现不同可以解释其临床表现上的差异。

MRI and MRA in Moyamoya Disease:Comparison Between Children and Adult Onset Types

Objective We retrospectively studied the MRI and MRA appearances of 10 patients,(6 children,4 adults) with Moyamoya disease.Methods MRI and MRA images were analyzed.For the MRA images,it was concerned that whether there were occlusive changes of the internal carotid artery and middle cerebral artery and whether there were collateral vessels.For the MRI images,the locations of the infarct lesions were studied.Results For the MRA images,the internal carotid arteries and the middle cerebral arteries were observed stenosis,and collateral vessels were formed in cerebral hemispheres.There were no remarkable differences between the children and adult groups with regard to the occlusive changes or to the flow void sign on MRA.However,Moyamoya disease in children exhibited a significant increase in the cortical and subcortical infarction(75%,9/12).In contrast,there were much more deep white matter infarctions in the centrum semiovale and basal ganglia in the adult group(87.5%,7/8)than in the children group(33.3%,4/12).Conclusion MRI and MRA are the method of choice in diagnosis of Moyamoya disease.The differences in the site of infarctions between the childhood and the adult Moyamoya disease observed on MRI may explain the differences in the clinical presentation.