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CT灌注成像在评估有症状烟雾病血流动力学中的应用:关注患侧及参数特征

Application of CT perfusion to assess hemodynamics in symptomatic Moyamoya syndrome: focus on affected side and parameter characteristic.

作者信息

Huang Shuran, Gao Lingyun, Chen Yueqin, Guo Xiang, Liu Deguo, Wang Jiehuan, Shi Zhitao, Sun Zhanguo, Jin Feng, Chen Weijian, Yang Yunjun

机构信息

Department of Intensive Care Medicine, Affliated Hospital of Jining Medical University, Jining, China.

Department of Radiology, Affliated Hospital of Jining Medical University, Jining, China.

出版信息

Childs Nerv Syst. 2018 Jun;34(6):1189-1197. doi: 10.1007/s00381-018-3727-8. Epub 2018 Jan 27.

Abstract

OBJECTIVE

Vascular and hemodynamic changes were not consistent in symptomatic and non-symptomatic cerebral hemisphere in patients with symptomatic moyamoya syndrome (MMS). Thus, the purpose of this study is to evaluate the hemodynamic difference between symptomatic and non-symptomatic cerebral hemisphere in patients with symptomatic MMS.

METHODS

Patients who were diagnosed with symptomatic MMS were retrospectively collected. All cases underwent CTP examination. Regions of interest (ROIs) were chosen in the mirroring bilateral frontal lobes, temporal lobes, the basal ganglia, and the brainstem as control region. The relative perfusion parameter values of symptomatic side were compared with non-symptomatic side.

RESULTS

Of the 40 patients, 33 patients were taken into assessment. In all cases (n = 33), rCBF, rMTT, and rTTP in all regions of interest (ROIs) of the symptomatic side were significantly different from those of contralateral side. In unilateral MMS patients (n = 7), rCBF values were not significantly different between two sides in the temporal lobe and basal ganglia area; rTTP values were significantly higher in the symptomatic side. rMTT values were significantly higher only in the temporal lobe of symptomatic side. In bilateral MMS patients (n = 26), rCBF and rMTT in all ROIs of the symptomatic side were significantly different from those of contralateral side. However, there were no significant differences between two sides in all ROIs on rTTP values.

CONCLUSIONS

This study demonstrates that rCBF and rMTT were more sensitive than rTTP for evaluating hemodynamic changes in patients with symptomatic bilateral MMS. Furthermore, patients with unilateral MMS may have a preserved rCBF compared to those with bilateral disease.

摘要

目的

有症状烟雾病综合征(MMS)患者的有症状和无症状脑半球的血管及血流动力学变化并不一致。因此,本研究旨在评估有症状MMS患者有症状和无症状脑半球之间的血流动力学差异。

方法

回顾性收集诊断为有症状MMS的患者。所有病例均接受CTP检查。在双侧额叶、颞叶、基底节和脑干的镜像区域选择感兴趣区(ROI)作为对照区域。将有症状侧的相对灌注参数值与无症状侧进行比较。

结果

40例患者中,33例纳入评估。在所有病例(n = 33)中,有症状侧所有感兴趣区(ROI)的rCBF、rMTT和rTTP与对侧相比均有显著差异。在单侧MMS患者(n = 7)中,颞叶和基底节区两侧的rCBF值无显著差异;有症状侧的rTTP值显著更高。rMTT值仅在有症状侧的颞叶显著更高。在双侧MMS患者(n = 26)中,有症状侧所有ROI处的rCBF和rMTT与对侧相比均有显著差异。然而,rTTP值在所有ROI处两侧无显著差异。

结论

本研究表明,对于评估有症状双侧MMS患者血流动力学变化,rCBF和rMTT比rTTP更敏感。此外,与双侧疾病患者相比,单侧MMS患者的rCBF可能得以保留。

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