CAJ | 학술논문

目的研究成年出血性烟雾病患者的临床特点及DSA表现. 方法对CT诊断为颅内出血,并经DSA确诊的68例烟雾病患者进行临床资料和DSA影像资料分析. 结果 68例患者中男23例,女45例,平均37.8岁.DSA表现:双侧前循环病变57例,合并后循环改变19例;单侧前循环病变9例,合并后循环改变6例；单纯后循环病变2例,单纯前循环病变41例.合并脑动脉瘤患者11例,其中7例进行了栓塞或开颅夹闭术.合并脑梗死患者13例.2次以上反复出血17例.脑室出血59例,脑实质出血7例,蛛网膜下腔出血2例.因脑出血量较大,需行开颅手术者6例. 结论成人出血性烟雾病主要表现为脑室内出血,尤其中年女性多见.积极针对合并动脉瘤及症状的外科干预多能取得良好治疗效果,但难以防止再次出血.脑DSA是明确分析烟雾病病变特征及选择治疗方法的首要手段.
목적 연구성년출혈성연무병환자적림상특점급DSA표현. 방법 대CT진단위로내출혈,병경DSA학진적68례연무병환자진행림상자료화DSA영상자료분석. 결과 68례환자중남23례,녀45례,평균37.8세.DSA표현:쌍측전순배병변57례,합병후순배개변19례;단측전순배병변9례,합병후순배개변6례；단순후순배병변2례,단순전순배병변41례.합병뇌동맥류환자11례,기중7례진행료전새혹개로협폐술.합병뇌경사환자13례.2차이상반복출혈17례.뇌실출혈59례,뇌실질출혈7례,주망막하강출혈2례.인뇌출혈량교대,수행개로수술자6례. 결론 성인출혈성연무병주요표현위뇌실내출혈,우기중년녀성다견.적겁침대합병동맥류급증상적외과간예다능취득량호치료효과,단난이방지재차출혈.뇌DSA시명학분석연무병병변특정급선택치료방법적수요수단.
Objective To study the clinical characteristics and digital subtract angiography (DSA) manifestations of the hemorrhagic moyamoya disease in adults. Methods A retrospective study was conducted to analyze the clinical data and DSA imaging of 68 adult patients who had been diagnosed with intracerebral hemorrhage on CT and with moyamoya on DSA. Results They were 23 males and 45 females with an average of 37.8 years. Their DSA manifestations included bilateral lesions on the anterior cerebral circulation in 57 cases, 19 of whom had combined lesions on the posterior cerebral circulation; unilateral lesion on the anterior cerebral circulation in 9 cases, 6 of whom had combined lesions on the posterior cerebral circulation; simple lesions on the posterior cerebral circulation in 2 cases;simple lesions on the anterior cerebral circulation in 41 cases.Intracranial aneurysm was complicated in 11 cases, 7 of whom underwent aneurysm embolization or clipping of the aneurysm neck. Cerebral infarction was complicated in 13 cases. Repeated hemorrhage for twice or more occurred in 17 cases.Ventricle hemorrhage occurred in 59 cases, parenchymal hemorrhage in 7 cases, and subarachnoid hemorrhage in 2 cases. Craniotomy was performed in 6 cases of massive intracranial bleeding.Conclusions Adult patients with hemorrhagic moyamoya disease, particular middle-aged women,usually have a major manifestation of intraventricular hemorrhage. Surgical interventions for combined aneurysms and symptoms can achieve a good therapeutic effect, but it is difficult to prevent re-hemorrhage.DSA is the primary method to determine specific characteristics of moyamoya lesions and consequently to choose a proper treatment.