目的探讨256层容积CT血管造影 灌注成像在烟雾病诊断中的应用效果。 方法 在2013年1月至2014年12月间，选 择齐齐哈尔医学院附属第三医院CT室 采用256层螺旋CT检查的27例烟雾病患 者资料作为研究对象，所有患者均具有 DSA诊断资料，图像后处理采用最大密度 投影(Maximal Intensity Projection, MIP)、容积再现(Volume Rendering, V R ) 、 多 平 面 重 建 ( M u l t i p l a n a r Reformatting, MRP)等方法，观察对血 管异常狭窄及闭塞的诊断效果；同时观 察灌注成像脑血流量（cerebral blood flow, CBF）、脑血容量(cerebral blood volume CBV)、达峰时间（time to peek, TTP）对烟雾病患者颅内血供的评价效 果。结果 27例患者CTA图像均能显示异常 血管狭窄、闭塞影像，与DSA比较诊断灵 敏度和准确度为100%，同时灌注成像发 现，在血供丰富和血供减少的血管网区与 对侧参考区比较，结果均具有统计学意义 （P<0.05）。结论 应用256层螺旋CT图像 后处理技术对颅内的异常血管网及血管狭 窄、闭塞等能够进行良好的显示；脑组织 灌注成像能够清晰显示脑内血流灌注状 态，有效评价血流的动力学改变，本方法 在针对烟雾病诊断中具有良好的应用前 景。

Objective To discuss the diagnosis of moyamoya disease with the 256 slices volumes perfusion CT angiography. Methods Selected 27 cases of Moyamoya disease patients as study,from the Third Affiliated Hospital of Qiqihar Medical University between January 2013 to December 2014, all patients had DSA diagnostic data, used Maximal Intensity Projection(MIP), volume rendering (VR), multiplanar reconstruction(MRP) and other methods to reconstruct image, while observing cerebral perfusion flow (CBF), cerebral blood volume (CBV), time to peek(TTP) to evaluate the supply with Moyamoya disease patients. Results 27 patients CTA image can show abnormal vascular stenosis, occlusion of the image, and DSA compare the diagnostic sensitivity and accuracy of 100%, while perfusion imaging found in blood supply and blood supply to reduce the vascular network area with the contralateral comparison reference area The results were statistically significant (P <0.05). Conclusion 256-slice CT image post-processing techniques intracranial vascular network and vascular abnormalities stenosis, occlusion, etc. can be a good method; brain perfusion imaging can clearly show the brain perfusion status, effective evaluation of dynamic changes in blood flow this method has a good prospect for moyamoya disease at diagnosis.