Severe haemodynamic stress in selected subtypes of patients with moyamoya disease: a positron emission tomography study
Severe haemodynamic stress in selected subtypes of patients with moyamoya disease: a positron emission tomography study
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DOI：
10.1136/jnnp.2003.025049
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发表时间：
2005-05-01
影响因子：
11
通讯作者：
Ohno, K
中科院分区：
文献类型：
--
作者：
Nariai, T;Matsushima, Y;Ohno, K
背景：烟雾病患者的最佳治疗方法仍存在争议。目的：通过正电子发射断层扫描（PET）测量脑血流动力学和代谢，回顾性研究血流动力学应激程度与临床表现之间的相关性。57例烟雾病患者年龄12 ~ 64岁，平均32岁，根据临床表现分为5组，进行脑血流量（CBF）、脑血容量（CBV）、脑氧代谢率（CMRO 2）和氧提取分数（OEF）使用O-15标记气体。患者组的区域值进行了比较，与正常group.Results：CBF在无症状的患者，患者表现为短暂性脑缺血发作（TIA），出血发作（H）的患者并没有显着低于正常对照组在任何地区。在大多数地区，TIA组和TIA相关梗死患者（I/TIA）的CBV显著高于对照组。I/TIA组额叶、顶叶和颞叶皮层的OEF显著高于对照组。H组和永久性功能障碍伴梗死（PD组）患者代谢降低，OEF正常。多变量分析测试的三维向量（CBF，CBV，OEF）的分布显示，除了NS v H和H v PD在额叶cortex.Conclusions：烟雾病的血流动力学状态是不均匀的，严重的血流动力学应激发生在选定的亚组的患者之间的每一个可能的对之间的六组之间的显着差异。
Background: The optimum management of patients with moyamoya disease remains controversial. Objectives: To examine retrospectively the correlation between the degree of haemodynamic stress and the clinical presentation by measuring cerebral haemodynamics and metabolism using positron emission tomography (PET).Methods: 57 patients with moyamoya disease (mean age 32 years, range 12 to 64), classified into five groups according to clinical manifestations, underwent PET measurement of cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rate for oxygen (CMRO2), and oxygen extraction fraction (OEF) using O-15 labelled gases. The regional values in patient groups were compared with a normal group.Results: CBF in non-symptomatic patients, patients presenting with transient ischaemic attacks (TIA), and patients with haemorrhagic onset (H) was not significantly lower than in normal controls in any region. CBV in the TIA group and in patients with infarction associated with TIA (I/TIA) was significantly higher than in the controls in most regions. OEF in the frontal, parietal, and temporal cortex was significantly higher in the I/TIA group than in the controls. Patients in the H group and those with a permanent deficit with infarction (PD group) had decreased metabolism with normal OEF. Multivariate analysis to test the distribution of the three dimensional vector (CBF, CBV, OEF) showed significant differences between every possible pair among the six groups except NS v H and H v PD in the frontal cortex.Conclusions: The haemodynamic status of moyamoya disease is not uniform, and severe haemodynamic stress occurs in selected subgroups of patients.