Quantitative Study On Changes Of Microcirculation And Blood-brain Barrier In Patients With Moyamoya Disease Before And After Operation By DCE-MRI

Objective:To evaluate the collateral circulation of moyamoya disease by dynamic contrast-enhanced MRI?DCE-MRI?in patients with moyamoya disease.Methods:To analyze 20 cases with moyamoya disease at the same time diagnosed by DSA and/or CTA,conventional MRI,T1 enhanced scan and DCE-MRI examination were selected.According to the distribution of blood supply of anterior,middle and posterior cerebral arteries and perforating arteries,the selections of the basal ganglia,coronal radiation level were divided into 22cerebral parenchymal zones,using DSA?DSA on the 22 partitions?collateral score?0,1,2 and 3?;DCE-MRI was used to calculate the partition of vascular volume exchange constant(K^trans),according to the value of K^transrans score?0,1,2and 3?,the 22 districts K^transrans and DSA branch conduct Kappa consistency test?P<0.05 has statistical significance?;the value of K^transrans in the region of preoperative cerebral hemisphere lesions significant were compared with the mirror side of brain parenchyma;the value of K^transrans and volume fraction of plasma of the postoperative lesions significant were compared with that of same zones of brain parenchyma after bypass surgery.They both used paired t test.Results:1.the K^transrans value in DCE-MRI was generally consistent with the results of DSA in patients with moyamoya disease?Kappa=0.314,P<0.05?;2.the value of K^transrans in the cerebral hemispheres was significantly higher than that in the mirror side?t=2.688,P<0.05?,and the K^transrans of the same cerebral parenchyma decreased one week after bypass grafting operation.The volume fraction of plasma increased?t=2.959,P<0.05?.There was no significant difference between the two parameters of K^transrans value before and after operation?t=1.451,P=0.07>0.05?.Conclusions:1.The consistency between collateral circulation and DSA results in patients with moyamoya disease is generally consistent with K^transrans value.It possibly existed the situation of high K^transrans score and low DSA score in some acute phase patients,it is necessary to evaluate the consistency between them at the appropriate time node.The matching degree of chronic period may be higher;2.The K^transrans value of the area of interest on the cerebral hemisphere was higher than that of the mirror side,and the permeability of capillary vessel in the region increased,so as to quantitatively assess the degree of damage to the blood brain barrier;3.One week after bypass grafting,the K^transrans value of the lesion was significantly lower than that of the same cerebral parenchyma area,but there was no significant difference,mainly because the blood-brain barrier had not recovered in some regions in the short time after bypass grafting;4.The Vp value of the lesion was significantly higher after operation than that before operation.It suggested that the vascularity of small vessels could significantly increase after bypass grafting,and the condition of microcirculation improved rapidly,indicating that Vp value was a sensitive quantitative index to judge the improvement of microcirculation after bypass grafting.