磁共振灌注成像在联合血管重建术治疗烟雾病中的应用  

The value of MR perfusion imaging in treatment of moyamoya disease treated by combined revascularization

作　　者：周平[1] 邓燕[1] 王辉[1] 汪超甲[1] 刘开军[1] 李安荣[1] 周一[1] 陈劲草[2] 

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)神经外科,445000 [2]武汉大学附属中南医院神经外科

出　　处：《临床神经外科杂志》2016年第3期197-200,共4页Journal of Clinical Neurosurgery

摘　　要：目的探讨磁共振(MR)灌注成像在烟雾病联合血管重建术治疗中的应用价值。方法回顾性分析24例采用颞浅动脉-大脑中动脉搭桥+颞肌贴附术治疗的烟雾病患者的MR灌注成像资料。将术前、术后1周和术后3个月的MR灌注成像数据,相对脑血容积(r CBV)、相对脑血流量(r CBF)和相对平均通过时间(r MTT)值进行收集、整理后进行统计学分析。结果所有患者术前MR灌注成像表现为额叶、颞叶不同程度低灌注,术后1周发现术侧额颞部灌注较术前有所好转,术后3个月改善更为明显。将各参数均值分别行方差分析,将方差分析差异有统计学意义的变量进一步进行LSD-t检验,发现术前与术后1周额叶r CBF、MTT的差异无统计学意义(均P>0.05),与术后3个月相比差异有统计学意义(均P<0.05);术后1周及术后3个月与术前枕叶r CBV相比差异有统计学意义(P<0.05)。结论 MR灌注成像技术能够有效评估联合血管重建术前后患者脑血流动力学的改变,因此能有效评估其治疗效果。Objective To study the value of magnetic resonance perfusion imaging in the treatment of moyamoya disease. Methods The MR perfusion imaging data of 24 cases of moyamoya disease treated by superficial temporal artery-middle cerebral artery bypass ＋ temporalis muscle attachment（ STA-MCA bypass ＋ EMS） were analyzed retrospectively. The value of relative cerebral blood flow （ rCBF）, relative cerebral blood volume （ rCBV ）, relative mean transit time （MTF） before the operation, after 1 week and after 3 months, were collected and compared. Results The MRI perfusion imagine of all patients before the operation showed that frontal and temporal lobe hypo peffusion in varying degrees. We found that perfusion of the frontotemporal lobe of the operative sides improving after 1 week, but more obviously after 3 months. Each parameter mean variance analysis were performed. The variable analysis of variance was significant, further LSD-test showed that there were no significant difference between the MTF of frontal lobes before and 1 week after operation （ P 〉 0.05 ） and that there was no significant difference between the rCBV of frontal lobes before and 1 week after the operation （ P 〉 0.05 ） , while compared with which 3 months after operation there were significant between them （ all P 〈 0.05 ）. There was significant differences of occipital lobe rBV before and after sugery, but no significance compaired 1 week with 3 months after operation （P 〉 0.05 ）. Conclusions MR resonance perfusion imaging could demonstrate the cerebral hemodynamic changes in patients before and after surgery, it could assess the treatment effectively.

关 键 词：烟雾病 血管重建 磁共振灌注成像 

分 类 号：R743.4[医药卫生—神经病学与精神病学]