Study On Application Of The Intraoperative Perfusion Computer Tomography In The Surgical Treatment Of Cerebral Vascular Diseases

Objective: To evaluate the sensitivity and reliability of intraoperativeperfusion computer tomography (PCT) in the surgical treatment ofcerebralvascular diseases and the impact of intraoperative PCT on surgicalstrategy modification for cerebralvascular diseases. Methods: Perfusioncomtuper tomography was taken in15patients with cerebrovasuculardisease (10with intracranial a neurysm,4with internal carotid arterystenosis,1with dural arteriovenous fistula) after anesthesia and atthe end of surgical treatment in the operation-room. The originaldata transferred to the CT workstation to get the color-codedparameter maps of CB F, CBV and TTP, the basal ganglia level andanother regions of interest (ROI) were chosen to calculate thequantitative and relative data, and then, comparison and analysis ofthe quantitative and relative data (CBF/rCBF、CBV/rCBV、TTP/rTTP)was taken place with software， at last, we compare the result withother monitoring methods such as SSEP, TCD and ICG. Results:intraoperative PCT can provide high quality color-coded parametermaps in short time, rCBF and rTTP are sensi tive in cerebral tissueperfusion changes in which there is a statistically significantdifference (P<0.05). iPCT and SSEP both are sensitive to cerebralhypoperfusion and iPCT is more sensitive to hyperperfusion thenSSEP. iPCT reflects cerebral perfusion more objectively than TCDand ICG. Conclusion: iPCT was shown to be feasible with short acquisitiontime, little interference with the surgical workflow, and very good diagnosticimaging quality. Thus, these modalities might be very helpful in evaluating theeffect and prognosis of cerebralvascular neurosurgery.