Evaluation Of Hemodynamic Changes In Patients With Moyamoya Disease Before And After STA-MCA Revascularization By 3D PCASL

First part:Quantitative Cerebral Perfusion Imaging in Moyamoya Disease:Comparison of multi-delay 3D pCASL and CTPObjective To compare the clinical value of multi-delay three-dimensional pseudo continuous arterial spin labeling imaging(3D pCASL)and CT perfusion imaging(CTP)in moyamoya disease(MMD).Methods 29 patients with MMD confirmed by DSA were enrolled.All the patients underwent 3D pCASL acquisition with PLD of 1500ms.?1800ms.?2500ms and CTP imaging.Region of interests were draw on both side of anterior.?middle.?posterior and basal ganglia cerebral artery territory.ASL-CBF of different PLD were calculated,as well as the CTP parameters:cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and peak time(TTP).K-S statistics and Pearson correlation coefficient test were used to compare the consistency between ASL-CBF and CTP parameters.According to DSA,all the patients were divided into lesion group and normal group,the consistency between ASL-CBF and CTP parameters were analysised in lesion group.Results(1)There were significant differences in ASL-CBF between different PLD.(2)For 1500ms.?1800ms?2500ms PLD,there were significant correlation between ASL-CBF and CTP-CBF.?CTP-MTT?CTP-TTP(P<0.01).There were no correlation between ASL-CBF and CTP-CBV(P=0.255?0.569?0.088).(3)In the lesion group,there were significant correlation between ASL-CBF and CTP-CBF.?CTP-MTT?CTP-TTP(P<0.001)There were no correlation between ASL-CBF and CTP-CBV(P=0.419?0.639?0.190).Conclusion For evaluation of cerebral perfusion in MMD,there were significant correlations between ASL-CBF and CTP-CBF?CTP-MTT?CTP-TTP,especially in the lesion areas.The multi-delay ASL-CBF also can be used as an index of impaired CVR.Second part:Evaluation of Hemodynamic Changes in Patients with Moyamoya Disease before and after STA-MCA Revascularization by 3D PcaslObjective To evaluate the effect of 3D pCASL on hemodynamics in patents with moyamoya disease before and after STA-MCA revascularization.Methords 44 patients with moyamoya disease treated by STA-MCA revascularization in our hospital were selected as the subjects and the brain perfusion imaging was performed by 3D pCASL with PLD times of 1.5s and 2.5s?The ASL perfixsion images of the patients were observed before and after operation,and on the operation side and non-operation side,the changes of absolute CBF and rCBF before and after operations were analyzed with different PLD times.Results Of the 44 patients,24 underwent left bypass,20 right bypass,30 first bypass and 14 second bypass.The dynamic changes of cerebral blood flow perfusion before and after operation were observed by ASL perfusion images.In different PLD times,the CBF value of the operative side and the non-operative side increased significantly,and the difference between the pre-operative and post-operative had significant statistical significance(P<0.05).There was no significant difference in pre-operative and non-operative[P=0.130(PLD1.5s)P=0.794(PLD2.5s)].The CBF value of operative side was significantly higher than that of non-operative side(P<0.05).The ratio of the operative side to the non-operative side was relative cerebral blood flow(rCBF).In different PLD times,the rCBF value increased significantly after operative.The difference between the preoperative and the postoperative was statistically significant(P<0.05).Before and after operation,there was no significant difference in rCBF values between PLD=1.5s and PLD=2.5s(P=0.14.?0.889.?1.46.?0.151).Conclusion Dual-delay 3D pCASL can dynamically display the hemodynamic changes in patients with moyamoya disease,and can effectively evaluate the improvement of cerebral blood flow in patients with moyamoya disease after STA-MCA.It is of great significance to evaluate the hemodynamic changes in patients with moyamoya disease after vascular reconstruction.