Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Sci Rep. 2017 May 31;7(1):2587. doi: 10.1038/s41598-017-02588-1.
In this study, we evaluated the differences in hemodynamics between hemorrhagic and non-hemorrhagic moyamoya disease (MMD) and moyamoya syndrome (MMS) by measuring cerebral circulation time (CCT). This case-control study included 136 patients with MMD or MMS diagnosed between April 2015 and July 2016 at Beijing Tian Tan Hospital. Each hemisphere was analyzed separately. The difference in clinical, radiological characteristics and CCT between subtypes of MMD and MMS were analyzed statistically. The results showed that total CCT between hemorrhagic and non-hemorrhagic sides was not statistically different (16.55 s vs. 16.06 s, P = 0.562). The cerebral filling circulation time (CFCT) of hemorrhagic sides was significantly shorter than that of non-hemorrhagic sides (4.52 s vs. 5.41 s, P < 0.001), and the cerebral venous circulation time (CVCT) of hemorrhagic sides was significantly longer than that of non-hemorrhagic sides (12.02 s, vs. 10.64 s, P < 0.001). The ratio of CFCT to CVCT (F-V ratio) was inversely correlated with the possibility of hemorrhagic stroke. Therefore, we conclude that the rapid filling and poor venous drainage of cerebral circulation are likely risk factors of hemorrhagic stroke secondary to MMD or MMS. The F-V ratio can be used to identify individuals at high risk of hemorrhagic stroke.
在这项研究中,我们通过测量脑循环时间(CCT)来评估出血性和非出血性烟雾病(MMD)和烟雾病综合征(MMS)之间的血液动力学差异。这项病例对照研究包括了 2015 年 4 月至 2016 年 7 月在北京天坛医院诊断的 136 例 MMD 或 MMS 患者。每个半球分别进行分析。统计分析了 MMD 和 MMS 各亚型之间的临床、影像学特征和 CCT 的差异。结果表明,出血侧和非出血侧的总 CCT 无统计学差异(16.55s 比 16.06s,P=0.562)。出血侧的脑充盈循环时间(CFCT)明显短于非出血侧(4.52s 比 5.41s,P<0.001),出血侧的脑静脉循环时间(CVCT)明显长于非出血侧(12.02s 比 10.64s,P<0.001)。CFCT 与 CVCT 的比值(F-V 比值)与出血性中风的可能性呈负相关。因此,我们得出结论,脑循环的快速充盈和静脉引流不良可能是 MMD 或 MMS 继发出血性中风的危险因素。F-V 比值可用于识别出血性中风高危个体。