Restoration of periventricular vasculature after direct bypass for moyamoya disease: intra-individual comparison
Restoration of periventricular vasculature after direct bypass for moyamoya disease: intra-individual comparison
复制标题
烟雾病直接搭桥术后脑室周围脉管系统的恢复：个体内比较
DOI：
10.1007/s00701-019-03866-9
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发表时间：
2019
影响因子：
2.4
通讯作者：
Miyamoto Susumu
中科院分区：
文献类型：
--
作者：
Miyakoshi Akinori;Funaki Takeshi;Takahashi Jun C;Takagi Yasushi;Kikuchi Takayuki;Yoshida Kazumichi;Kataoka Hiroharu;Mineharu Yohei;Okawa Masakazu;Yamao Yukihiro;Fushimi Yasutaka;Okada Tomohisa;Togashi Kaori;Miyamoto Susumu
背景脑室周围吻合是烟雾病中一种独特的异常血管系统，虽然已经研究了其与颅内出血的关系，但还没有研究涉及其在搭桥手术后的变化。作者试图测试直接搭桥手术是否可以恢复正常的脑室周围vascularis.MethodsPatients谁经历了直接搭桥手术烟雾病在一个单一的机构有资格参加这项研究。分别在术前、首次手术后和对侧二次手术后3 - 6个月进行基线、术后和随访磁共振血管造影（MRA）扫描。根据三种亚型（脑纹、丘脑和脉络膜吻合）对室周性脑病的滑动薄层最大强度投影冠状位MRA图像进行评分。基线和术后MRA图像进行了比较，以获得一个匹配的比较在手术和非手术半球内的个人（个体内比较）。手术半球的室周吻合评分显著降低（中位数，2比1;p< 0.001），而非手术半球的评分保持不变（中位数，2比2;p= 0.57）;手术和非手术半球之间的评分变化显著不同（p< 0.001）。在104个脑室周围吻合阳性的半球中，47个（45.2%）在随访MRA中被评估为阴性。在亚型中，脉络膜吻合最有可能被评估为阴性（阳性半球的79.7%）。脉络膜吻合的矫正可能性是一个需要进一步研究的课题。
BackgroundWhile periventricular anastomosis, a unique abnormal vasculature in moyamoya disease, has been studied in relation to intracranial hemorrhage, no study has addressed its change after bypass surgery. The authors sought to test whether direct bypass surgery could restore normal periventricular vasculature.MethodsPatients who had undergone direct bypass surgery for moyamoya disease at a single institution were eligible for the study. Baseline, postoperative, and follow-up magnetic resonance angiography (MRA) scans were scheduled before surgery, after the first surgery, and 3 to 6 months after contralateral second surgery, respectively. Sliding-thin-slab maximum-intensity-projection coronal MRA images of periventricular anastomoses were scored according to the three subtypes (lenticulostriate, thalamic, and choroidal anastomosis). Baseline and postoperative MRA images were compared to obtain a matched comparison of score changes in the surgical and nonsurgical hemispheres within individuals (intra-individual comparison).ResultsOf 110 patients, 42 were identified for intra-individual comparisons. The periventricular anastomosis score decreased significantly in the surgical hemispheres (median, 2 versus 1;p< 0.001), whereas the score remained unchanged in the nonsurgical hemispheres (median, 2 versus 2;p= 0.57); the score change varied significantly between the surgical and nonsurgical hemispheres (p< 0.001). Of the 104 periventricular-anastomosis-positive hemispheres undergoing surgery, 47 (45.2%) were assessed as negative in the follow-up MRA. Among the subtypes, choroidal anastomosis was most likely to be assessed as negative (79.7% of positive hemispheres).ConclusionsPeriventricular vasculature can be restored after direct bypass. The likelihood of correction of choroidal anastomosis is a subject requiring further studies.
烟雾病儿童患者的长期临床和手术结果
DOI：
--
发表时间：
2004
期刊：
Nervous System in Child 29
影响因子：
--
作者：
Asao T;Kuwano H;et al.;T.Ozawa
通讯作者：
T.Ozawa
影响因子：
8.3
作者：
Miyamoto, Susumu;Yoshimoto, Takashi;Takahashi, Jun C.
通讯作者：
Takahashi, Jun C.