Voxel Based Analysis of Surgical Revascularization for Moyamoya Disease: Pre- and Postoperative SPECT Studies.
Voxel Based Analysis of Surgical Revascularization for Moyamoya Disease: Pre- and Postoperative SPECT Studies.
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DOI：
10.1371/journal.pone.0148925
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Togashi K
中科院分区：
文献类型：
--
作者：
Fushimi Y;Okada T;Takagi Y;Funaki T;Takahashi JC;Miyamoto S;Togashi K
烟雾病（MMD）是一种慢性进行性脑血管闭塞性疾病，导致基底神经节和丘脑区域侧支通路（烟雾血管）异常扩大。脑血运重建术仍然是烟雾病患者的首选治疗方法，可以改善受损的脑血流量（CBF）。然而，基于术前和术后数据的基于体素的烟雾病血运重建手术分析（VBA）尚未建立。采用统计参数映射函数（SPM8）为VBA引入了最新的Diffeomorphic anatomy Registration Through Exponentiated Lie Algebra （DARTEL）算法，SPM8利用该算法实现了改进的配准。本研究采用VBA方法评价SPM8加DARTEL算法对MMD的术前和术后单光子发射计算机断层扫描（SPECT）图像，并将结果与SPM8不加DARTEL（常规方法）的结果进行比较。本研究纳入32例首次行颞浅动脉-大脑中动脉（STA-MCA）搭桥手术的烟雾病患者，所有患者均行术前和术后3D t1加权成像和SPECT检查。术前、术后SPECT图像与3D t1加权图像进行配准，然后进行VBA。SPM8联合DARTEL术后SPECT显示旁路侧大脑半球CBF面积增加（58,989体素，P<0.001），术后CBF增加比例小于15%。同时，术后SPECT显示SPM8未加DARTEL的CBF增加面积较小。综上所述，对烟雾病患者进行了VBA， SPM8与DARTEL显示，术后SPECT显示CBF在相对较大的区域内增加，且最多增加15%的比例具有统计学意义。
Moyamoya disease (MMD) is a chronic, progressive, cerebrovascular occlusive disease that causes abnormal enlargement of collateral pathways (moyamoya vessels) in the region of the basal ganglia and thalamus. Cerebral revascularization procedures remain the preferred treatment for patients with MMD, improving the compromised cerebral blood flow (CBF). However, voxel based analysis (VBA) of revascularization surgery for MMD based on data from pre- and postoperative data has not been established. The latest algorithm called as Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra (DARTEL) has been introduced for VBA as the function of statistical parametric mapping (SPM8), and improved registration has been achieved by SPM8 with DARTEL. In this study, VBA was conducted to evaluate pre- and postoperative single photon emission computed tomography (SPECT) images for MMD by SPM8 with DARTEL algorithm, and the results were compared with those from SPM8 without DARTEL (a conventional method). Thirty-two patients with MMD who underwent superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery as the first surgery were included and all patients underwent pre- and postoperative 3D T1-weighted imaging and SPECT. Pre- and postoperative SPECT images were registered to 3D T1-weighted images, then VBA was conducted. Postoperative SPECT showed more statistically increased CBF areas in the bypassed side cerebral hemisphere by using SPM8 with DARTEL (58,989 voxels; P<0.001), and increased ratio of CBF after operation was less than 15%. Meanwhile, postoperative SPECT showed less CBF increased areas by SPM8 without DARTEL. In conclusion, VBA was conducted for patients with MMD, and SPM8 with DARTEL revealed that postoperative SPECT showed statistically significant CBF increases over a relatively large area and with at most 15% increase ratio.