CT perfusion assessment of Moyamoya syndrome before and after direct revascularization (superficial temporal artery to middle cerebral artery bypass).
OBJECTIVE
To evaluate the utility of CT perfusion (CTP) for the assessment of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with Moyamoya syndrome (MMS).


METHODS
Twenty-four consecutive MMS patients, who underwent unilateral STA-MCA bypass surgery, received CTP before and after surgery. The relative perfusion parameter values of surgical hemispheres before treatment were compared with post-treatment values. All patients underwent CT angiography (CTA) before and after surgery in order to confirm the patency of bypass.


RESULTS
The follow-up CTA after surgery clearly demonstrated 20 (20/24, 83.3 %) bypass arteries, whereas four (16.7 %) bypass arteries were occluded or very small. Postoperative rMTT and rTTP values (P < 0.05) of the surgical side were significantly lower than pre-operation. In patients (n = 20) with bypass patency, postoperative rCBF, rMTT and rTTP values (P < 0.05) of the surgical side were significantly improved. However, the differences of all parameters were not significant (P > 0.05) in the patients (n = 4) without bypass patency after revascularization.


CONCLUSIONS
This study demonstrates that CTP can provide a crucial quantitative assessment of cerebral haemodynamic changes in MMS before and after STA-MCA anastomosis.


CONCLUSIONS
Twenty-four MMS patients undergoing STA-MCA bypass received CTP pre- and post-surgery. Cerebral haemodynamics improved on the surgical side post-surgery on CTP maps. rCBF might have a better correlation with patency of the bypass artery. CTP can evaluate cerebral perfusion changes in MMS patients after cerebral revascularization.
Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, 266003, China.|CT Department, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Yueqin
Y
Chen
Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, 266003, China. sdqdxuwenjian@163.com.
Wenjian
W
Xu
CT Department, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Xiang
X
Guo
CT Department, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Zhitao
Z
Shi
CT Department, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Zhanguo
Z
Sun
MR Department, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Lingyun
L
Gao
Department of Neurosurgery, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Feng
F
Jin
CT Department, the Affiliated Hospital of Jining Medical College, Jining, 272029, China.
Jiehuan
J
Wang
Department of Radiology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Weijian
W
Chen
Department of Radiology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Yunjun
Y
Yang
D000328:Adult; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D009072:Moyamoya Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D010477:Perfusion; D011184:Postoperative Period; D013699:Temporal Arteries / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
Angiography; Cerebral revascularization; Moyamoya syndrome; Multidetector computed tomography; Perfusion