| ObjectiveBy craniocerebral CT perfusion(CT perfusion,CTP)imaging technique for the analysis of moyamoya disease(MMD)patients with intracranial vascular revascula-rization cerebral hemodynamic changes after treatment,compared before and after operation in patients with MMD cerebral perfusion index,analysis of intracranial blood vessels outside along with the improvement of the cerebral hemodynamics in patients with MMD and evaluating the effect of surgery.Meanwhile,the perfusion index characteristics of postoperative patients with severe complication-hyperperfusion syndrome(HPS)were studied,and the differences of different cerebral blood flow perfusion indexes between postoperative HPS patients and non-hps patients were compared to analyze the correlation between cha-nges in cerebral hemodynamics and postoperative HPS.MethodsThirty-six patients with MMD who underwent intracranial and extracranial vascular reconstruction from December 2016 to January 2019 were selected from the brain department hospital of liaocheng people’s hospital.All patients underwent cerebral angiog-raphy(DSA)before the surgery to understand the development degree of intracranial smoky vessels and the diagnosis of MMD.Patients received head CTP examination before surgery and within 7 days after surgery,and relevant perfusion index data were obtained,namely cerebral blood flow(CBF),cerebral blood volume(CBV),peak time(TTP),and mean passage time(MMT).After determining the relevant positions of the selected disease side and mirror symmetry side as regions of interest(ROI),each perfusion index obtained was processed,and paired t test was used to analyze whether there were statistical differences in the relative value changes of CT perfusion index before and after surgery.The patients were divided into the HPS group and the non-hps group according to whether they had hyperperfusion syndrome after intracranial and extracranial vascular recons-truction.The difference of perfusion index between the two groups was analyzed,and the indexes reflecting clinical prognosis were obtained.ResultsIn this study,36 patients underwent intracranial and extracranial vascular reconstruction,and intracranial CTP examination within one week after surgery indicated that all patients had increased intraoperative cerebral blood flow(CBF)and cerebral blood volume(CBV),and 12 patients(HPS group)had increased postoperative CBF and CB-V more significantly than that before surgery.There was no significant change in peak time(TTP)in all patients.The mean passage time(MTT)of patients in the HPS group was significantly shorter than that before surgery,while the mean passage time(MTT)of pat-ients in the non-hps group was not significantly shorter than that before surgery.Preoperative and postoperative r CBF,r CBV and r MTT were compared in 36 MMD patients,and P<0.05.Comparison of r TTP before and after surgery in MMD patients,P value was >0.05.The difference of MTT values between HPS group and non-hps group before and after surgery.Conclusions1.CT perfusion imaging is of great significance for the assessment of cerebral hemodynamic changes before and after intracranial vascular reconstruction in MMD patients.2.MMD patients can rapidly improve cerebral hemodynamic abnormalities after surgical treatment.3.In MMD patients,intracranial CTP was performed within one week after intracranial and extracranial vascular reconstruction,and the possibility of hyperperfusion syndrome should be highly suspected if the operative hemisphere CBFand CBV were significantly higher than the contralateral,while the preoperative values of CBF and CBV were lower or basically symmetrical.4.The postoperative MTT value of patients in the HPS group was significantly greater than that of patients in the non-hps group,and the difference was statistically significant,indicating that the increase of MTT value was a reliableindicator to evaluate the occurrence of hyperperfusion. |
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