目的 分析烟雾病(MMD)及大脑中 动脉粥样硬化狭窄(ICAD)的高分辨磁共振 成像特点及鉴别诊断。方法 选取MMD及 ICAD患者各50例，分别纳入对照组、观 察组，两组均行血管壁-磁共振成像(HRMRI)检查，对比两组HR-MRI检查中大脑 中动脉(MCA)狭窄段血管壁外径与外缘面 积、狭窄类型(偏心/向心)、管壁信号 强度(是否均匀)及狭窄段周围侧支血管 形成率，并分析狭窄段血管壁外径与外 缘面积诊断MMD与ICAD的效能(灵敏度、 特异度、准确度)。结果 观察组狭窄段 血管壁外径(3.04±0.28)mm及外缘面积 (7.18±1.45)mm2 较对照组(1.76±0.42) mm、(2.72±1.61)mm2 大(P均＜0.05)； 观察组管腔偏心性狭窄44例(88.00％)， 向心性狭窄6例(12.00％)，对照组管腔 偏心性狭窄27例(54.00％)，向心性狭窄 23例(46.00％)，观察组管壁信号不均匀 率84.00％高于对照组48.00％，而对照 组狭窄段周围侧支血管形成率86.00％高 于观察组50.00％，组间比较差异均有统 计学意义(P均＜0.05)；狭窄段管壁外径 及外缘面积诊断ICAD的灵敏度90.48％、 准确度86.00％明显高于MMD 72.50％、 68.00％(P＜0.05)。结论 MMD及ICAD的高 分辨磁共振成像各具特点，其中狭窄段血 管壁外径与外缘面积、狭窄类型、管腔信 号强度及狭窄段周围侧支血管形成可作为 鉴别诊断点。

Objective To analyze the high-resolution magnetic resonance imaging features and differential diagnosis of moyamoya disease (MMD) and middle cerebral artery stenosis (ICAD). Methods Fifty patients with MMD and 50 patients with ICAD were respectively included in the control group and observation group. Both groups underwent vascular wall high-resolution magnetic resonance imaging (HR-MRI) examination. The outer diameter and outer edge area of stenotic vascular wall of middle cerebral artery (MCA) showed by HR-MRI, type of stenosis (eccentric/concentric), signal intensity of tube wall (homogeneous or not) and the formation rate of collateral vessels around the stenosis segment were compared between the two groups. The efficiency (sensitivity specificity, accuracy) of outer diameter and outer edge area of stenotic vascular wall in the diagnosis of MMD and ICAD was analyzed. Results The outer diameter and outer edge area of stenosis segment vascular wall in the observation group [(3.04±0.28)mm, (7.18±1.45) mm2 ] were larger than those in the control group [(1.76±0.42)mm, (2.72±1.61)mm2 ] (P<0.05); In the observation group, there was eccentric stenosis in 44 cases (88.00%) and concentric stenosis in 6 cases (12.00%), while in the control group, there were 27 cases (54.00%) and 23 cases (46.00%), respectively. The rate of inhomogeneous vascular wall signal in the observation group (84.00%) was higher than that in the control group (48.00%) while the formation rate of collateral vessels around the stenosis segment in control group (86.00%) was higher than that in the observation group (50.00%) (all P<0.05); The sensitivity and accuracy of outer diameter and outer edge area of stenosis segment vascular wall in the diagnosis of ICAD (90.48%, 86.00%) were significantly higher than those in the diagnosis of MMD (72.50%, 68.00%) (P<0.05). Conclusion The HR-MRI features of MMD and ICAD are different. The outer diameter and outer edge area of stenotic vascular wall, stenosis type, lumen signal intensity and formation of collateral vessels around the stenosis segment can be used as a diagnostic point.