Departments of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan.
Neurosurg Rev. 2011 Jul;34(3):355-62; discussion 362. doi: 10.1007/s10143-011-0331-8. Epub 2011 Jun 4.
We investigated whether postoperative hyperperfusion in moyamoya disease can be predicted using intraoperative laser Doppler flowmetry and/or thermography. A prospective study was conducted on 27 patients (39 hemispheres) with moyamoya disease who underwent superficial temporal artery-middle cerebral artery (STA-MCA) bypass. During surgery, regional cerebral blood flow (rCBF) was measured with a laser Doppler flowmeter and the temperature of the cortical surface was measured with an infrared thermograph. Postoperative hyperperfusion was assessed immediately after surgery based on CBF study under sedation (propofol) as >100% increase in corrected rCBF compared to preoperative values. Postoperative hyperperfusion on CBF was observed in two patients (7.4%). A significant correlation was observed between intraoperative rCBF changes and postoperative rCBF increase (Pearson's method: r=0.555, p=0.0003; simple regression: Y=1.22X+3.289, r (2)=0.308, p=0.0004). Furthermore, the rCBF changes measured by laser Doppler flowmetry were significantly greater in patients with postoperative hyperperfusion (p=0.0193) and CHS (p=0.0193). The present study suggests that intraoperative rCBF measurement using laser Doppler flowmetry may predict a risk of post-EC-IC bypass cerebral hyperperfusion in moyamoya disease.
我们研究了术中激光多普勒血流仪和/或热成像是否可以预测烟雾病术后过度灌注。对 27 例（39 个半球）接受颞浅动脉-大脑中动脉（STA-MCA）旁路手术的烟雾病患者进行了前瞻性研究。手术中，使用激光多普勒流量计测量局部脑血流量（rCBF），并使用红外热像仪测量皮质表面温度。根据镇静（异丙酚）下 CBF 研究，术后即刻评估术后过度灌注，即校正 rCBF 与术前值相比增加>100%。两名患者（7.4%）出现 CBF 术后过度灌注。术中 rCBF 变化与术后 rCBF 增加呈显著相关性（Pearson 法：r=0.555，p=0.0003；简单回归：Y=1.22X+3.289，r(2)=0.308，p=0.0004）。此外，激光多普勒血流仪测量的 rCBF 变化在术后过度灌注（p=0.0193）和 CHS 患者中明显更大（p=0.0193）。本研究表明，术中使用激光多普勒血流仪测量 rCBF 可能预测烟雾病患者颅内外旁路术后脑过度灌注的风险。
