成人烟雾病脑血流重建手术中不同亚型患者皮层脑电信号特征差异分析

Analysis on Differences of Electrocorticography Signal Features during Surgical Revascularization between Different Subtypes of Adult Moyamoya Disease

目的寻找反映烟雾病脑血流重建手术前后血流变化情况的信号特征,分析其在出血亚型与缺血亚型重建手术中的分布差异性。方法回顾性分析70例成人烟雾病患者在脑血流重建手术过程中的皮层脑电信号,提取不同频率段内能表征脑电信号特点的多类特征来反映信号幅度、离散程度、复杂度等方面的特性,筛选出其中对于临床分析有价值的特征,统计比较出血型和缺血型烟雾病患者脑电信号特征之间的差异及其在手术不同阶段的变化情况。结果筛选出了能够反映手术前后血流变化情况的脑电特征,包括幅度均值、幅度标准差、最大最小距离、Petrosian分形维数、对数差分均方根和归一化线段长度,这些特征在出血型和缺血型烟雾病患者中的分布具有显著性差异(P<0.05)。结论在烟雾病脑血流重建手术中,皮层脑电信号的多种统计特征可以用来反映血流变化情况。对于出血亚型和缺血亚型,这些特征的分布存在显著性差异,因此在基于脑电的术中监测和预后判断等应用中需要有针对性地加以分析。

Objective In order to monitor and predict the prognosis of moyamoya disease(MMD),this paper searches for the signal features of blood flow changes before and after cerebral blood flow reconstruction,and analyzes the distribution differences between hemorrhagic and ischemic subtypes.Methods The ECoG signals of 70 adult MMD patients during cerebral blood flow reconstruction surgery were retrospectively analyzed,and multiple types of features that characterized the ECoG signals in different frequency bands were extracted to reflect the signal amplitude,degree of dispersion,complexity,etc.,then the features that were valuable for clinical analysis were selected.The differences of ECoG signals’ features between patients with hemorrhagic and ischemic MMD as well as their changes in different stages of surgery were statistically compared.Results Several ECoG signals’ features that could reflect the changes of blood flow during the surgery were selected,including mean value,standard deviation,maximum-minimum distance,Petrosian fractal dimension,log root sum of sequential variations,and normalized line length.The distribution of these features were significant different(P<0.05)between the two subtypes.Conclusion In the reconstruction surgery of cerebral blood flow in MMD,various statistical features of ECoG signals could be used to reflect the changes in blood flow.The distribution of these features was significantly different for the subtypes of hemorrhagic and ischemic.Thus targeted analysis should be made in the two subtypes for applications such as intraoperative monitoring and prognostic judgment based on ECoG.