成人烟雾病MRI表现与MRA血管分级的相关性研究

目的:分析成人烟雾病磁共振成像（MRI）表现与磁共振血管（MRA）分级及异常代偿血管网的关系，为烟雾病的临床干预提供理论依据。方法:回顾性分析50例行大脑MRI及MRA检查的成人烟雾病患者的临床资料，根据Houkin’s评级方法分别对每侧大脑半球进行MRA评级，同时对颅底烟雾状血管网（MMV）的个数进行评分。分别评价脑MRI表现（脑出血、急性脑梗塞、脑软化灶及脑萎缩）与MRA分级及MMV评分的相关性。结果:不同MRA分级脑出血、脑缺血差异有统计学意义（χ2=13.04，P=0.005；χ2=8.21，P=0.04），MRA分级Ⅱ、Ⅲ级患者脑出血发生率较高，Ⅰ、Ⅳ级患者急性脑梗塞发生率较高；不同MMV评分脑出血、脑软化灶差异有统计学意义（χ2=24.79，P<0.001；χ2=11.42，P=0.02），MMV评分4和5分患者脑出血发生率较高，1和2分患者脑软化灶发生率较高。结论:MRA分级及MMV的形成在一定程度上提示烟雾病（MMD）脑血管事件的发生，初步预测脑血管事件的发生的可能，为临床预防MMD脑血管事件的发生提供指导意义。 

Relationship between MRI Performance and Vascular Score of MRA in Adult Moyamoya Disease

Objective: To analyze the relationship between MRI and vascular score of MRA in adult Moyamoya disease (MMD), and to provide a theoretical basis for the clinical intervention of MMD. Methods: Analyze the clinical data of 50 adult patients with MMD performed by MRI and MRA. According to the Houkin`s rating method, MRA was performed on each side of the cerebral hemisphere, and the number of Moyamoya vessels (MMV) was also scored. The correlations between brain MRI manifestations (cerebral hemorrhage, cerebral ischemia, cerebral softening and brain atrophy) and MRA classification and MMV score were evaluated. Results: There were significant differences in cerebral hemorrhage and cerebral ischemia between different MRA classifications (χ2=13.04,P=0.005;χ2=8.21,P=0.04). The incidence of cerebral hemorrhage in patients with MRA grade II and III is higher, and the incidence of acute cerebral infarction in patients with grade I and IV is higher. There were significant differences in cerebral hemorrhage and cerebral softening between different MMV scores (χ2=24.79,P<0.001;χ2=11.42,P=0.02). The incidence of cerebral hemorrhage in patients with MMV scores 4, 5 points was higher, and the incidence of cerebral softening was higher with 1, 2 points. Conclusion: The MRA classification and the formation of MMV suggest the occurrence of cerebrovascular events in MMD to some extent, and preliminarily predict the possibility of cerebrovascular events, which can provide guidance for clinical prevention of cerebrovascular events in MMD.