How does angiogenesis develop in pediatric moyamoya disease after surgery? A prospective study with MR angiography
How does angiogenesis develop in pediatric moyamoya disease after surgery? A prospective study with MR angiography
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DOI：
10.1007/s00381-004-0971-x
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发表时间：
2004-10-01
影响因子：
1.4
通讯作者：
Nonaka, T
中科院分区：
文献类型：
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作者：
Houkin, K;Nakayama, N;Nonaka, T
对象：在接受搭桥手术的烟雾病患者中观察到的新生血管形成的动态过程尚未得到充分阐明。磁共振血管造影（MRA）有望揭示这一过程，因为它可以经常进行，因为它的非侵入性的性质。在本研究中，我们使用重复MRA前瞻性研究了术后新生血管。研究方法：我们研究了14例（23侧）在过去3年中接受了颞浅动脉（STA）至大脑中动脉的直接搭桥手术和脑-硬脑膜-动脉-肌-血管联合的间接手术的儿童患者。使用1.5 T机器，512 x 256分辨率的图像序列和飞行时间方法进行MRA。术前前瞻性进行MRA，术后1、3和6个月重复MRA。结论：术后1个月，烟雾血管有减少的趋势，STA也有发展的趋势。术后3个月观察颞深动脉和脑膜中动脉的发育情况。术后狭窄的进展明显加快。人工诱导的血管形成之间的相互关系的搭桥手术和烟雾血管，这是应该补偿狭窄的变化，颈内动脉，被披露。
Object: The dynamic process of neovascularization seen in patients with moyamoya disease who have received bypass surgery has not been sufficiently elucidated. Magnetic resonance angiography (MRA) is expected to disclose this process since it can be conducted frequently because of its non-invasive nature. In this study, we prospectively investigated postoperative neovascularization using repeated MRA. Methods: We studied 14 pediatric patients ( 23 sides) who have received both direct bypass surgery of the superficial temporal artery (STA) to middle cerebral artery and indirect surgery of encephalo-duro-arterio-myo-synangiosis during the past 3 years. MRA was performed using a 1.5-T machine, image sequences of 512 x 256 resolution, and the time-of-flight method. MRA was prospectively performed preoperatively and repeated 1, 3, and 6 months after surgery. Conclusions: A tendency toward a decrease in moyamoya vessels and the development of the STA was observed 1 month after the surgery. Development of the deep temporal artery and the middle meningeal artery was observed 3 months after the surgery. The progression of stenotic change was apparently accelerated after the surgery. A reciprocal relation between neovascularization artificially induced by bypass surgery and moyamoya vessels, which are supposed to compensate for the stenotic change of the internal carotid artery, was disclosed.