Xiang Guo1, Xuexia Yuan1, Lingyun Gao1, Yueqin Chen1, Hao Yu1, Weijian Chen2, Yunjun Yang2, Zhen Chong1, Zhanguo Sun1, Feng Jin3, Deguo Liu4. 1. Department of Radiology, The Affiliated Hospital of Jining Medical University, Jining, China. 2. Department of Medical Imaging, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 3. Department of Neurosurgery, The Affiliated Hospital of Jining Medical University, Jining, China. 4. Department of Radiology, The Affiliated Hospital of Jining Medical University, Jining, China. sdjnliudeguo@163.com.
Abstract
OBJECTIVE: To explore the value of computed tomography perfusion (CTP) imaging for evaluating the efficacy of encephaloduroarteriosynangiosis (EDAS) treatment of moyamoya syndrome (MMS). METHODS: Forty-three patients with MMS (48 hemispheres) who received EDAS treatment were examined using CTP and DSA before and after surgery. CTP of the ipsilateral cortex, contralateral mirror area, and pons region were measured, and the relative cerebral blood flow (rCBF) and volume (rCBV), mean transit time (rMTT), and time-to-peak (rTTP) were calculated. Based on postoperative DSA, 48 hemispheres were apportioned to two groups based on rich (grades 2, 3) or poor (grades 0, 1) collateral vessel formation, and the pre- and post-operative differences in perfusion changes were compared. The association between clinical outcome, CTP, and the degree of DSA collateral vessels was explored. RESULTS: rCBF and rMTT significantly improved in both the poor and rich collateral vessel formation groups (n = 21 and 27, respectively), while rTTP significantly improved only in the latter. Postoperative CTP improved in the rich and the grade 1 collateral vessel groups (p < 0.01). The clinical improvement was consistent with the improvement of CTP (p = 0.07), but less consistent with the degree of collateral angiogenesis (p = 0.003). CONCLUSION: CTP can quantitatively evaluate the improvement of brain tissue perfusion in the operated area after EDAS. Brain tissue perfusion in operated areas improved regardless of postoperative rich or poor collateral vessel formation observed via DSA. A significant improvement in rTTP in the operated area may indicate the formation of abundant collateral vessels. KEY POINTS: • CTP showed that brain tissue perfusion in the operated area after EDAS improved regardless of rich or poor collateral vessel formation observed via DSA. • Significant improvement of rTTP in the operated area may indicate the formation of abundant collateral vessels.
OBJECTIVE: To explore the value of computed tomography perfusion (CTP) imaging for evaluating the efficacy of encephaloduroarteriosynangiosis (EDAS) treatment of moyamoya syndrome (MMS). METHODS: Forty-three patients with MMS (48 hemispheres) who received EDAS treatment were examined using CTP and DSA before and after surgery. CTP of the ipsilateral cortex, contralateral mirror area, and pons region were measured, and the relative cerebral blood flow (rCBF) and volume (rCBV), mean transit time (rMTT), and time-to-peak (rTTP) were calculated. Based on postoperative DSA, 48 hemispheres were apportioned to two groups based on rich (grades 2, 3) or poor (grades 0, 1) collateral vessel formation, and the pre- and post-operative differences in perfusion changes were compared. The association between clinical outcome, CTP, and the degree of DSA collateral vessels was explored. RESULTS: rCBF and rMTT significantly improved in both the poor and rich collateral vessel formation groups (n = 21 and 27, respectively), while rTTP significantly improved only in the latter. Postoperative CTP improved in the rich and the grade 1 collateral vessel groups (p < 0.01). The clinical improvement was consistent with the improvement of CTP (p = 0.07), but less consistent with the degree of collateral angiogenesis (p = 0.003). CONCLUSION:CTP can quantitatively evaluate the improvement of brain tissue perfusion in the operated area after EDAS. Brain tissue perfusion in operated areas improved regardless of postoperative rich or poor collateral vessel formation observed via DSA. A significant improvement in rTTP in the operated area may indicate the formation of abundant collateral vessels. KEY POINTS: • CTP showed that brain tissue perfusion in the operated area after EDAS improved regardless of rich or poor collateral vessel formation observed via DSA. • Significant improvement of rTTP in the operated area may indicate the formation of abundant collateral vessels.
Authors: Nestor R Gonzalez; Joshua R Dusick; Mark Connolly; Firas Bounni; Neil A Martin; Barbara Van de Wiele; David S Liebeskind; Jeffrey L Saver Journal: J Neurosurg Date: 2015-06-12 Impact factor: 5.115
Authors: Christopher L Hallemeier; Keith M Rich; Robert L Grubb; Michael R Chicoine; Christopher J Moran; DeWitte T Cross; Gregory J Zipfel; Ralph G Dacey; Colin P Derdeyn Journal: Stroke Date: 2006-04-27 Impact factor: 7.914