目的 探讨CT血管造影术(CTA)在 成人烟雾病患者诊断中的应用价值。方 法 以2013年3月-2017年1月我院收治的45 例疑似成人烟雾病患者为对象，纳入患 者入院后均行头颈部CTA检查，以脑血管 造影(DSA)结果为金标准，观察成人烟雾 病患者CTA影像学表现，并评估CTA对成 人烟雾病的诊断价值。结果 45例患者经 CAT检查，血管存在不同程度狭窄10例、 有出血性症状15例、缺血性症状20例， 两侧颈内动脉末端都明显累及共20例、 累及左侧18例、累及右侧7例，椎基底动 脉狭窄、代偿性扩张、无明显变化各5、 21、19例；以DSA为金标准，CTA对成人 烟雾病诊断的灵敏度为90.00%(27/30)、 特异度为86.67%(13/15)、准确率为 88.89%(40/45)，kappa一致性为0.754； CTA对成人烟雾病各血管狭窄评分与DSA评 分比较差异无统计学意义(P＞0.05)。结 论CTA对成人烟雾病患者的诊断效能高， 可较准确评估患者脑部各血管狭窄程度。

Objective To investigate the application value of CT angiography (CTA) in the diagnosis of moyamoya disease in adults. Methods A total of 45 adults with suspected moyamoya disease treated in our hospital during the period from March 2013 to January 2017 were enrolled in this study. All patients underwent head and neck CTA after admission. The CTA imaging findings of adults with moyamoya disease were observed with the results of cerebral digital subtraction angiography (DSA) as the golden standard. The value of CTA in the diagnosis of moyamoya disease in adults was evaluated. Results Results of CTA showed that there were different degrees of vascular stenosis in 10 cases, hemorrhagic symptoms in 15 cases and ischemic symptoms in 20 cases among the 45 patients. Ends of the both sides of the internal carotid artery were obviously involved in 20 cases, the left side was involved in 18 cases and the right side was involved in 7 cases. There were 5 cases with vertebrobasilar stenosis, 21 cases with compensatory dilatation and 19 cases without obvious changes. With DSA as the golden standard, the sensitivity, specificity, accuracy and kappa consistency of CTA in the diagnosis of moyamoya disease were 90.00% (27/30), 86.67% (13/15), 88.89% (40/45) and 0.754 respectively. There was no significant difference of scores CTA and DSA in the diagnosis of vascular stenosis in adult moyamoya disease (P>0.05). Conclusion CTA has high diagnostic efficacy in adults with moyamoya disease, and it can accurately assess the degree of stenosis of cerebral vessels in patients.