Yun Tae Jin, Cheon Jung-Eun, Na Dong Gyu, Kim Woo Sun, Kim In-One, Chang Kee-Hyun, Yeon Kyung Mo, Song In Chan, Wang Kyu-Chang
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, Korea.
Radiology. 2009 Apr;251(1):216-23. doi: 10.1148/radiol.2511080654.
To evaluate whether perfusion magnetic resonance (MR) imaging can depict hemodynamic status after revascularization surgery and whether changes at perfusion MR imaging after revascularization surgery correspond with clinical outcome in moyamoya disease.
An institutional review board approved this retrospective study; informed consent was waived. Pre- and postoperative perfusion MR imaging data in 67 children with moyamoya disease (mean age, 7.2 years; range, 2-13 years) were included. Regional time to peak (rTTP) and regional cerebral blood volume (rCBV) were calculated by adjusting cerebral time to peak (TTP) and cerebral blood volume (CBV) values by using cerebellar reference values. For quantitative regional analysis, pixel values were divided into five categories (>0, >2, >4, >6, and >8 seconds), and percentages of pixels in rTTP meeting these time conditions were calculated. Changes in the values after revascularization were calculated. Postoperative clinical outcomes were categorized as follows: 1 indicated excellent; 2, good; 3, fair; and 4, poor. Pre- and postoperative perfusion parameters were compared by using a paired t test; relationships between perfusion parameters and clinical outcomes were investigated by using one-way analysis of variance, with a significance level of .05.
rTTP, rCBV, and percentage of pixels of rTTP decreased significantly after revascularization surgery. Pre- and postoperative rTTP were significantly different for the clinical outcome categories. Change in rTTP and change in percentage of pixels of rTTP (>0 seconds to >6 seconds) were significantly different for the clinical outcome categories.
TTP and CBV perfusion maps can depict hemodynamic status after revascularization surgery in moyamoya disease. Furthermore, changes in TTP perfusion maps after revascularization surgery correspond with clinical outcome in patients with moyamoya disease.
评估灌注磁共振（MR）成像能否描绘血运重建术后的血流动力学状态，以及血运重建术后灌注MR成像的变化是否与烟雾病的临床结局相关。
机构审查委员会批准了这项回顾性研究；无需知情同意。纳入67例烟雾病患儿（平均年龄7.2岁；范围2 - 13岁）的术前和术后灌注MR成像数据。通过使用小脑参考值调整脑达峰时间（TTP）和脑血容量（CBV）值来计算局部达峰时间（rTTP）和局部脑血容量（rCBV）。对于定量局部分析，像素值分为五类（>0、>2、>4、>6和>8秒），并计算rTTP中满足这些时间条件的像素百分比。计算血运重建后这些值的变化。术后临床结局分类如下：1表示优秀；2，良好；3，中等；4，差。使用配对t检验比较术前和术后灌注参数；使用单因素方差分析研究灌注参数与临床结局之间的关系，显著性水平为0.05。
血运重建术后rTTP、rCBV和rTTP的像素百分比显著下降。不同临床结局分类的术前和术后rTTP存在显著差异。不同临床结局分类的rTTP变化和rTTP像素百分比变化（>0秒至>6秒）存在显著差异。
TTP和CBV灌注图可描绘烟雾病血运重建术后的血流动力学状态。此外，血运重建术后TTP灌注图的变化与烟雾病患者的临床结局相关。
