Correlation between Clinical Presentations and Hemodynamic Parameters Measured by Dynamic Susceptibility Contrast Magnetic Resonance Imaging in Adult Patients with Moyamoya Disease
Correlation between Clinical Presentations and Hemodynamic Parameters Measured by Dynamic Susceptibility Contrast Magnetic Resonance Imaging in Adult Patients with Moyamoya Disease
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DOI：
10.1016/j.jstrokecerebrovasdis.2017.06.057
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发表时间：
2017-12-01
影响因子：
2.5
通讯作者：
Maehara, Taketoshi
中科院分区：
文献类型：
--
作者：
Hirai, Sakyo;Inaji, Motoki;Maehara, Taketoshi
背景：脑血流动力学检查是烟雾病（moyamoya disease，MMD）患者临床治疗中不可缺少的。在这项研究中，我们研究了MMD成人患者的临床表现和动态磁敏感对比磁共振成像（DSC-MRI）测量的血流动力学参数之间的相关性。研究方法：对122例MMD患者的157个大脑半球进行了DSC-MRI检查，测量了局部相对脑血容量（CBV）和相对平均通过时间（MTT）。根据临床表现将患者分为4组：无症状组（NS）、出血组（H）、梗死组（I）和短暂性脑缺血发作组（T）。比较各组局部CBV和MTT值。结果：T组和I组CBV的相对值明显高于NS组（P <0.01）。H组仅额叶皮层CBV高于NS组。3个症状组之间无显著统计学差异。在大脑皮层的所有区域中，与小脑相比，T组和I组的MTT延长（MTT延迟）显著高于NS组（P <0.05）。H组额叶和Rolandic区的MTT延迟显著低于T组（P <0.05）。结论：DSC-MRI测量的血流动力学参数反映了MMD患者的不同临床表现。DSC-MRI是一个有用的方式来评估个别成人患者的临床状况与MMD。
Background: The examination of cerebral hemodynamics is indispensable for the clinical management of patients with moyamoya disease (MMD). In this study, we examined the correlation between clinical presentations and hemodynamic parameters measured by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in adult patients with MMD. Methods: One hundred fifty-seven hemispheres in 122 adult patients with MMD were examined by DSC-MRI to measure the regional relative cerebral blood volume (CBV) and relative mean transit time (MTT). The patients were divided into 4 groups based on their clinical presentations: a nonsymptomatic (NS), hemorrhagic (H), infarction (I), and transient ischemic attack (T) group. The regional CBV and MTT values were compared among the 4 groups. Results: The relative value of CBV was significantly higher in groups T and I than in the NS group (P < .01). The CBV of group H was higher than that of the NS group only in the frontal lobe cortex. There were no significant statistical differences among the 3 symptomatic groups. Prolongation of the MTT in comparison with the cerebellum (MTT delay) was significantly higher in groups T and I than in the NS group in all regions of the cerebral cortex (P < .05). The MTT delay was significantly lower in group H than in group T in the frontal lobe and the Rolandic area (P < .05). Conclusions: Hemodynamic factors measured by DSC-MRI reflected the variable clinical presentations of patients with MMD. DSC-MRI is a useful modality for evaluating the clinical conditions of individual adult patients with MMD.