The Application Of MR Perfusion-weighted Imaging In Patients With Moya-moya Disease Before And After Operation

Objective:Combined vascular reconstruction method is a common treatment method for curing moyamoya disease. In this study, application of magnetic resonance perfusion imaging technology, we tested four hemodynamics parameters of the moyamoya disease patients, and we assessed the effects of treatments before and after surgery using the mRS (Modified Rankin Scale) rating system. Through statistical analysis to evaluate the value of magnetic resonance perfusion imaging before and after surgery can reflect the application value of MR perfusion imaging technology.Materials and Methods:In this study we collected 12 confirmed cases of moyamoya disease patients using the whole brain DSA examination before surgery, and did the brain magnetic resonance perfusion imaging test to all the patients before and after the surgery using the Siemens 3.0T superconducting magnetic resonance instrument. For every patients we choose four different parts of brain for magnetic resonance perfusion imaging test, including basal ganglia, frontal lobe, temporal lobe, occipital lobe part. We detect the MR results one week before and one month after the surgery and we tried our best to choose the same part of the four interesting parts in order to ensure the true and reliable results. At the same time we avoided the large blood vessels and obvious infarction parts as far as possible. After the brain magnetic resonance perfusion imaging test, we can get the parameters of cerebral blood volume (CBV), cerebral blood flow information (CBF), mean flow through time (MTT), time to peak (TTP) of pseudo-color pictures at each selected brain lever. Then we compared these four parameters with the results of the control parts, thus we can get the results of rCBV, rCBF, rMTT, and rTTP. Using the statistical method we analyzed the four hemodynamics parameters including CBV, CBF, MTT and TTP before and after the surgery, then we evaluated the effects of the combined vascular reconstruction method for curing moyamoya disease using these results. So we can define the application value of the magnetic resonance perfusion imaging technology in the clinical treatment of moyamoya disease.Results:In this study, we sued the mRS rating system to evaluate the magnetic resonance perfusion imaging results of all the 12 moyamoya disease patients confirmed by the whole brain DSA examination before surgery one week before and one month later after the combined vascular reconstruction surgery. The magnetic resonance perfusion imaging results showed that the degree of perfusion of the frontal lobe, temporal lobe increased at the operative side, suggesting that the disease has improved to a large extent one month after the surgery compared to that before surgery. The statistical analyses of the four hemodynamics parameters including CBV, CBF, MTT and TTP before and after the surgery showed that the relative cerebral blood flow information (rCBF) of frontal lobe and temporal lobe improved to a large extent and the relative mean flow through time (rMTT) decreased to a large extent one month after the surgery compared to that before surgery, and these results were statistic significant (P<0.05); but the relative decrease of cerebral blood volume (rCBV) and relative time to peak (rTTP) were not statistic significant (P>0.05). The rCBV decreased a lot and the rTTP decreased to a large extent at occipital lobe part one month after the surgery compared to that before surgery, and these results were statistic significant (P<0.05); but the differences of rCBF and rMTT at occipital lobe part were not statistic significant (P>0.05). At the temporal lobe part, only rMTT became shorter one month after the surgery compared to that before surgery, and this result was statistic significant (P<0.05); but the statistical differences of the other there parameters rCBV, rCBF and rTTP were not statistic significant (P>0.05).Conclusions:Magnetic resonance perfusion imaging technology is a useful method to analyze the four hemodynamics parameters including CBV, CBF, MTT and TTP before and after the surgery. This method can effectively show the differences between the microcirculation level of brain perfusion at different areas of the brain before and after the surgery. Our study confirmed that the magnetic resonance perfusion imaging technology is a useful method to assess the effectiveness of moyamoya disease surgical treatment...