Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
J Stroke Cerebrovasc Dis. 2013 Aug;22(6):862-8. doi: 10.1016/j.jstrokecerebrovasdis.2012.07.010. Epub 2012 Aug 29.
Flow voids in the basal ganglia cannot always be recognized on magnetic resonance imaging, even in patients with typical moyamoya disease. In this report, flow voids in the basal ganglia and cisternal flow voids of the sylvian valley were evaluated in patients with moyamoya disease, and their diagnostic value was verified. A total of 41 consecutive patients with moyamoya disease were included in this analysis. The number of flow voids in the basal ganglia and the sylvian valley were counted on each side by 3 observers. Then the numbers of flow voids were compared between the patients with moyamoya disease and controls. The patients with moyamoya disease had a significantly higher mean number of flow voids in the basal ganglia and the sylvian valley (P < .0001); however, the number of flow voids in the basal ganglia was 0 or 1 in 69 sides (28.0%) in patients with moyamoya disease. Comparative analysis using the area under the receiver operating curve indicated that the evaluation of flow voids in the sylvian valley was significantly superior method to that in the basal ganglia (P < .0001). The cutoff value for the number of cisternal flow voids in the sylvian valley for the diagnosis of moyamoya disease was 6. Based on these findings, we recommend a definitive diagnosis of moyamoya disease should include assessment for abnormal vessels around the terminal portions of the internal carotid arteries.
基底节的血流空影在典型的烟雾病患者中也并非总能在磁共振成像上识别，本研究旨在评估烟雾病患者基底节和脑裂内的血流空影，并验证其诊断价值。共纳入 41 例连续的烟雾病患者，3 位观察者分别对侧别基底节和脑裂内的血流空影数量进行计数，比较烟雾病患者和对照组的血流空影数量。烟雾病患者基底节和脑裂内的血流空影数量明显多于对照组（P <.0001）；但在 69 侧（28.0%）患者中基底节血流空影数量为 0 或 1。受试者工作特征曲线下面积的比较分析显示，脑裂内血流空影的评估明显优于基底节（P <.0001）。脑裂内血流空影数量的截断值为 6，对诊断烟雾病有意义。综上，我们建议对颈内动脉终末段周围异常血管进行评估，以明确烟雾病的诊断。
