The Value Of64-slice Spiral CT Angiography In The Diagnosis Of Brain Vessels Disease

Background and purposeCerebrovascular disease (CVD)is one of the three diseases cause human deaths。In the world,460million people dead becouse of cerebrovascular disease every year.Illness and death people are most of over65years old. Japan is one of the countrieswhich are the highest of incidence and mortality of cerebrovascular disease. Mortalityof cerebrovascular disease has been the No.1among the leading cause of death. Chinais also in areas of high stroke mortality, it is estimated that6million resident fallCerebrovascular disease now, the number of1,300,000people fall CVD and1millionpeople dead. In survivors about3/4people left sequelae like hemiplegia, etc. Somepatients lose the ability of work and life。Acute cerebrovascular disease are generallydivided into two types of ischemic and hemorrhagic.Currently the gold standard of diagnasing CVD is still DSA, but it is high-riskand expensive, It is not suitable for emergency examination and clinical screening.With the development of multi-slice spiral CT technology, CT cerebral vascularimaging not only can be clearly demonstrated that the intracranial vascularmorphology, but also it’s a small risk, economy, rapid. More and more clinicians canchoose the CTA checks instead of DSA diagnosis of cerebrovascular disease.The first partCTA Study of the Relation between the Variation of Willis’Circle and Aneurysm&Cerebral infarctionObjective To observe the morphology and patterns of Willis circle in healthyChinese by using CT imaging of cerebral blood vessels(CTA), discussing the relation between the variation of Willis circle and brain vessels disease.Material and Methods Collecting111patients with head and neck CTA, divideinto asymptomatic group、aneurysm group and cerebral infarction group, and divideWillis ring into four types typeⅠ、Ⅱ、Ⅲ、Ⅳ,compare analyzing the situation of threegroups’ Willis ring.Result In111patient, Willis arterial circle normality has17casea,it was15.3%,Willis arterial circle abnormality has94cases, it was84.7%.Of asymptomatic group,variation rate was85.1%, aneurysm group was86.1%, cerebral infarction group was89.2%. Comparing variation rate of aneurysm group with asymptomatic group, therewas no statiscally significant difference (P＞0.05); but,in the variation rate of A1、thedisplaying rate of PCoA、the variation rate of P1and the happening rate of FTP,twogroups were statiscally significant difference, aneurysm group of the variation rate ofA1and the displaying rate of PCoA was higher than asymptomatic group,asymptomatic group of the variation rate of P1and the happening rate of FTP washigher than aneurysm group.Comparing variation rate of cerebral infarction groupwith asymptomatic group, there was statiscally significant difference (P＜0.05),cerebral infarction group of the variation rate of A1was higher than asymptomaticgroup, there was statiscally significant difference.Conclusion The Variation of Willis’ Circle maybe closely related with Aneurysmand Cerebral infarction. The second partThe value of64-slice spiral CT angiography in the diagnosisof adult Moyamoya diseaseObjective Retrospective analysis of25cases of MMD patients with head CTAimaging features, to explore the value of head CTA examination. Methods Collected25patients with moyamoya disease by cranial CTA duringJanuary2011December-2012, and retrospectively analyzed their imaging features.Result25patients showed stenosis or occlusion of the internal carotid arteries or theirbranches and extensive abnormal basicranial vascular network,88%of cases hadextensive abnormal basicranial vascular network,12%of cases had fewer;84%ofpatients formed collateral vessels and16%of patients did not have; The patients ofMoyamoya disease with aneurysm were20%.Conclusion The CTA can clearly show stenosis or occlusion of blood vessels,moyamoya vascular, aneurysm and collateral vessel, it can be used as the first choiceimaging of moyamoya disease.