Clinical Features And Imaging Studies Of Moyamoya Disease

Purpose Analysis of moyamoya disease epidemiology,pathogenesis,clinical features,imaging findings and treatment method,comparison of digital subtraction angiography(DSA)and CT angiography(CTA)in terms of their respective acharacteristics and value in the diagnosis of moyamoya disease.Methods 1.Retrospective collection of imaging examination data and clinical manifestations of 41 cases of adult MMD patients admitted between November 2013 and January 2018 at xiqing hospital of tianjin city and general hospital of tianjin medical university.2.The patients were divided into ischemic group and hemorrhage group according to cerebrovascular events.The epidemiological characteristics,clinical manifestations,imaging findings and prognosis of the two groups were compared.3.Analyze the characteristics of the head DSA and CTA of patients with smoke disease,and discuss the advantages and disadvantages of the diagnosis of the disease.4.Evaluate the therapeutic effect and prognosis of cerebrovascular bypass surgery.5.Data statistics were processed using SPSS 20.0 statistical software.Conform to the normal measurement data comparison between the two groups using T test,count variable using 2 test,for orderly variables between groups take the univariate analysis of variance,inspection level for a = 0.05,P < 0.05 think difference was statistically significant.Results 1.The average age of the first onset of the disease was 35.95,plus or minus 13.93,with a ratio of 3:2,from tianjin and the neighbouring regions of hebei province,without ethnic minorities,and the family history of the two persons was investigated.There was no statistically significant difference in gender,average age,age composition,and onset seasons of ischemic group and bleeding group.The proportion of smoking in the ischemic group was higher than that in the hemorrhage group,the difference was statistically significant,and 33.3% of the patients had obvious inducement before onset.2.The most common clinical manifestations of patients were headache dizziness,limb movement disorder and sensory abnormality,followed by visual abnormality,language and consciousness disorder.In the hemorrhage group,headache and dizziness,consciousness disorder was the first symptom,and the proportion of body movement disorder in ischemic group was higher than that in the hemorrhage group.3.Pathology revealed: ipsilateral superficial temporoparietal artery wall slightly thickened with a small amount of calcium salt deposition,luminal stenosis is not obvious,the small dural arterial intima hyperplasia of different level,part of the small arteries dilate with partial bleeder,meningeal organization slightly fleshy.4.Ischemia group in 90.2% patients with acute infarction lesions located in the side of the brain hemispheres,involving the posterior circulation,35.5% 65.3% infarcts for multiple,and there are differences between the conventional infarcts vascular distribution range,44.8% patients with brain atrophy.81.8% of the patients in the hemorrhage group were in the brain parenchyma,36.4% of the patients were in the ventricle,27.3% were involved in the subarachnoid space,27.3% of the patients had multiple cavities,and 18.2% of the patients had brain atrophy.5.The proportion of the posterior cerebral artery was higher than the bleeding group,and the difference was statistically significant.There were also statistically significant differences between the two groups of the posterior cerebral artery Mugikur.There was no statistically significant difference between the two groups.In the hemorrhage group,3 patients were diagnosed with aneurysm,and no subarachnoid hemorrhage occurred.6.DSA was higher than CTA and ICA detection rate was higher than CTA.Stenosis or occlusion of MCA and ACA and smoke veins discovery rate,DSA and CTA is no significant difference of apparent after the choroid and subcallosal weeks artery and ophthalmic artery blood vessels the compensatory difference between CTA and DSA detection rate is not big,small blood vessels CTA is often part of a display is not clear.7.A few months after the operation of the patients with temporalis muscle adhesion,the angiography showed a small amount of external carotid artery system to anastomosis of the internal carotid artery.Conclusion 1.30-40 age group of moyamoya disease patients prone to intracerebral hemorrhage;2.The onset of adult smoke is the first symptom of headache and consciousness disorder,and the first symptom is physical activity and sensory impairment in the patients with blood type,while the children with TIA are the main symptoms.3.The infarcts in adult patients with MMD are often multiple and repetitive,which do not conform to the conventional vascular distribution area,and the hemorrhage is prone to the lateral ventricle and subarachnoid space.4.The detection rate of DSA lesions is higher than that of CTA,and the convenience and relatively noninvasive of CTA can be used as a means of screening for the disease.