单侧烟雾病大脑中动脉供血区血管情况与灌注状态的相关性研究

Correlation study between vascular conditions and perfusion status in unilateral moyamoya disease

目的：探讨单侧烟雾病（MMD）大脑中动脉（MCA）供血区血管情况与灌注状态的相关性，为更加个体化地评估血流动力学状态提供客观依据。方法回顾性分析2008年～2013年经天坛医院确诊的单一MCA受累的单侧MMD患者31例。分析MCA狭窄程度、侧支循环分级与MCA皮层的M1～M6区域CT灌注成像各灌注参数比值的相关性。统计学采用Spearman等级相关及多重线性回归检验。结果①大脑中动脉狭窄程度和灌注参数图的相关性：除M3区域的rCBF及M4区域各灌注参数比值外，各区域的rCBF与MCA的狭窄程度呈负相关，而rMTT及rTTP与MCA狭窄程度呈正相关；②侧支循环分级与灌注参数图的相关性：侧支循环分级与M5区域的rCBV、M6区域的rCBF、rCBV呈负相关，与M1区域的rMTT、M6区域的rMTT及rTTP呈正相关；③其他影响因素：年龄是影响M3区域rCBF、rMTT及rTTP变化的独立因素。结论单侧MMD患者的MCA狭窄程度、侧支循环分级及年龄均是影响灌注参数比值变化的重要因素。

Objective To investigate the correlation between vascular conditions in the territory of middle cerebral artery （MCA） and perfusion status with unilateral moyamoya disease （MMD） .The study may provide an objective base for a more individualized assessment of hemodynamic status .Methods A restrospective analysis of 31 patients with single MCA involvement in unilateral MMD ,whose diagnoses were confirmed in Tiantan Hosipital between 2008 and 2013 ,was performed .The relationship among the degree of MCA stenosis ,collateral grading and relative perfusion parameters in the M1-M6 regions of MCA cortex was performed .Spearman rank correlation test and multiple linear regression were used in the statistical analysis .Results ① The correlation between the degree of MCA stenosis and perfusion parameter map：rCBF positively correlated with the degree of MCA stenosis ,and rMTT ,rTTP negatively correlated with the degree of MCA stenosis in all regions except for rCBF in the M3 region and all relative perfusion parameters in the M4 region;②The correlation between collateral grading and perfusion parameter map：collateral grading negatively associated with rCBV in the M5 region ,rCBF and rCBV in the M6 region ,and positively associated with rMTT in the M1 region ,rMTT and rTTP in the M6 region;③ Other factors ：age was also independent factor that decreased rCBF ,prolonged rMTT and rTTP in the M3 region .Conclusion Degree of MCA stenosis ,collateral grading and age were important factors influen-cing relative perfusion parameters in all regions in unilateral MMD patients .