Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Sci Rep. 2021 Jan 12;11(1):479. doi: 10.1038/s41598-020-80036-3.
Moyamoya disease (MMD) is a chronic, steno-occlusive cerebrovascular disorder of unknown etiology. Surgical treatment is the only known effective method to restore blood flow to affected areas of the brain. However, there are lack of generally accepted noninvasive tools for therapeutic outcome monitoring. As dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) is the standard MR perfusion imaging technique in the clinical setting, we investigated a dataset of nineteen pediatric MMD patients with one preoperational and multiple periodic DSC MRI examinations for four to thirty-eight months after indirect revascularization. A rigid gamma variate model was used to derive two nondeconvolution-based perfusion parameters: time to peak (TTP) and full width at half maximum (FWHM) for monitoring transitional bolus delay and dispersion changes respectively. TTP and FWHM values were normalized to the cerebellum. Here, we report that 74% (14/19) of patients improve in both TTP and FWHM measurements, and whereof 57% (8/14) improve more noticeably on FWHM. TTP is in good agreement with Tmax in estimating bolus delay. Our study data also suggest bolus dispersion estimated by FWHM is an additional, informative indicator in pediatric MMD monitoring.
烟雾病（MMD）是一种病因不明的慢性、狭窄性脑血管疾病。手术治疗是恢复受影响大脑区域血流的唯一已知有效方法。然而，目前缺乏普遍接受的用于治疗效果监测的无创工具。由于动态对比磁共振成像（DSC MRI）是临床标准的磁共振灌注成像技术，我们对 19 名接受间接血运重建术的儿科 MMD 患者的数据集进行了研究，这些患者在术前进行了一次 DSC MRI 检查，并在术后 4 至 38 个月内进行了多次周期性 DSC MRI 检查。我们使用刚性伽马变量模型来得出两个无需解卷积的灌注参数：达峰时间（TTP）和半峰全宽（FWHM），分别用于监测过渡性团注延迟和分散变化。TTP 和 FWHM 值与小脑进行归一化。在此，我们报告 74%（14/19）的患者在 TTP 和 FWHM 测量中均有改善，其中 57%（8/14）在 FWHM 上的改善更为明显。TTP 在估计团注延迟方面与 Tmax 具有良好的一致性。我们的研究数据还表明，FWHM 估计的团注分散是儿科 MMD 监测的另一个有用指标。
