Study On Clinical Features And Imaging Characteristics Of42Adult Moyamoya Disease Patients

ObjectiveTo analyze the clinical features and imaging characteristics of moyamoya disease.Discuss the application value of transcranial Doppler(TCD),brain Computeried Tomography(CT),Multi—slice spiral CT angiography (MSCTA), Computeried Tomography perfusion(CTP),magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) in the diagnosis of moyamoya disease(MMD).MethodsA retrospective analysis of Clinical features and imaging charateristics of MMD was conducted on42adult MMD patients enrolled from March2006to Agust2012in the central hospital of JiaoZuo coal group and from September2012to July2013in the Xuanwu Hospital of Beijing. We reviewed the42adult MMD patients’age, gender, Symptoms, results of the imaging examinations.Results①This study was completely composed of adult patients and the age peak was around35～39years old.The male and female ratio was1:1.33②The most common first symptom in adults was cerebral hemorrhage(CH), with a total of25cases(59.52%),in the age group of more than30years old,including14cases of cerebral infarction patients and4cases of transient ischemic attack,1cases of dizziness and epilepsy. Under30years old group of4patients with transient ischemic attack,1cases of dizziness. The rest of the17cases (40.48%) with hemorrhagic cerebrovascular disease for starting symptoms, including cerebral hemorrhage (including ruptured into ventricle) in12cases (70.59%),3cases of subarachnoid hemorrhage (17.65%), single ventricle hemorrhage in2cases (11.74%).③Among22patients (52.38%) with TCD screening to detect abnormal vascular stenosis or occlusion at first and diagnosed by MSCTA or MRA and DSA finally;④On CT or MRI,there were cerebral infarction and cerebral hemorrhage in32cases (76.19%); MSCTA or MRA display artery basilar stenosis or occlusive lesions and smoke like abnormal blood vessel formation in34cases (80.95%).⑤Ten patients were examined by CTP,CBF decreased,CBV increased or decreased,MTT and TTP extension of frontal and temporal lobe in the disorder hemicerebrum.⑥All patients were examined by DSA, the different degrees of stenosis or occlusion of bilateral distal ICA and proximal MCA/ACA were found in42patients(100%);All cases show various forms of collateral circulation;72of the84ICA angiographies show moyamoya vessels,all of the moyamoya vessels were located at the basal ganglia area;4aneurysms were found.ConclusionThe age of onset MMD has one peak around the age of35to39in adults ischemic cerebral vascular disease is the maior,clinical manifestation; CT and MRI for the discovery of intracranial hemorrhagic lesions and ischemic lesions have different advantages; TCD should be used as the preferred screening of intracranial vascular stenosis of choice, if there are any abnormal, MRA or MSCTA examination further; DSA is the gold standard in diagnosis of MMD.