1Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland.
2Department of Neurosurgery, Careggi Hospital, University of Florence, Italy.
Neurosurg Focus. 2019 Feb 1;46(2):E7. doi: 10.3171/2018.11.FOCUS18502.
Blood oxygenation level-dependent functional MRI cerebrovascular reactivity (BOLD-CVR) is a contemporary technique to assess brain tissue hemodynamic changes after extracranial- intracranial (EC-IC) bypass flow augmentation surgery. The authors conducted a preliminary study to investigate the feasibility and safety of intraoperative 3-T MRI BOLD-CVR after EC-IC bypass flow augmentation surgery. Five consecutive patients selected for EC-IC bypass revascularization underwent an intraoperative BOLD-CVR examination to assess early hemodynamic changes after revascularization and to confirm the safety of this technique. All patients had a normal postoperative course, and none of the patients exhibited complications or radiological alterations related to prolonged anesthesia time. In addition to intraoperative flow measurements of the bypass graft, BOLD-CVR maps added information on the hemodynamic status and changes at the brain tissue level. Intraoperative BOLD-CVR is feasible and safe in patients undergoing EC-IC bypass revascularization. This technique can offer immediate hemodynamic feedback on brain tissue revascularization after bypass flow augmentation surgery.
血氧水平依赖功能磁共振脑血流反应性（BOLD-CVR）是一种评估颅外-颅内（EC-IC）旁路血流增强手术后脑组织血液动力学变化的现代技术。作者进行了一项初步研究，以调查 EC-IC 旁路血流增强手术后术中 3T MRI BOLD-CVR 的可行性和安全性。连续选择了 5 名患者进行 EC-IC 旁路血运重建术，进行术中 BOLD-CVR 检查，以评估血运重建后的早期血液动力学变化，并确认该技术的安全性。所有患者术后均恢复正常，无患者出现与麻醉时间延长相关的并发症或影像学改变。除了旁路移植物的术中流量测量外，BOLD-CVR 图还提供了有关脑组织水平血液动力学状态和变化的信息。在接受 EC-IC 旁路血运重建的患者中，术中 BOLD-CVR 是可行且安全的。该技术可以在旁路血流增强手术后为脑组织再血管化提供即时的血液动力学反馈。
