磁共振灌注成像在烟雾病血管重建术中的临床应用价值

Clinical value of brain MR perfusion-weighted imaging before and after revascularization in patients with moyamoya disease

目的探讨磁共振灌注成像(PWI)在烟雾病血管重建术中的应用价值。方法回顾性分析2015年1月到2018年1月血管重建术治疗的33例成年缺血型烟雾病的临床资料。术前、术后3个月,采用DSA检查评估血管重建术效果;采用PWI评估脑灌注。结果 33例中,术后27例临床表现明显好转。术后3个月,DSA显示脑部供血状况良好;PWI显示相对脑血容量增加不明显(P>0.05),但是额叶和颞叶相对脑血流量显著增加(P<0.05),相对平均血流通过时间和相对达峰时间均明显缩短(P<0.05)。结论 PWI可以定量地分析烟雾病血管重建术前后的脑血流动力学参数的变化,有效地评估手术效果。

Objective To investigate the clinical value of cerebral MR perfusion-weighted imaging(PWI)before and after the vascular reconstruction surgery in the patients with moyamoya disease.Methods The cerebral MR PWI before and after vascular reconstruction surgery was performed in 33 patients with ischemic moyamoya disease.The changes in preoperative and postoperative the cerebral hemodynamic parameters obtained by MR PWI were statistically analyzed.Results The clinical symptoms were significantly improved in 27 patients and insignificantly in 6 patients and DSA showed that the blood supply for the brain was significantly improved in all the patients after bypass surgery compared to those before the surgery.The cerebral PWI showed that the regional cerebral blood flow(rCBF)increased significantly(P<0.05),regional mean transit time(rMTT)And regional time to peak(rTTP)was significantly shortened compared to those before the surgery in all the patients(P<0.05).Conclusions The changes in the cerebral hemodynamic parameters before and after the revascularization may be quantitatively analyzed and the clinical effects of the bypass surgery may be objectively evaluated by cerebral MR PWI.