Abstract:

Objective: To evaluate the hemodynamic situation of the patients with moyamoya disease using MR perfusion imaging, and to explore the relationship between compensatory collateral circulation and perfusion. Methods: Seventy-two hospitalized patients with moyamoya disease were selected as typical moyamoya disease group, including 37 males and 35 females, aged 10-62 years old, all patients underwent cerebral angiography (DSA) and MR perfusion imaging. And 20 patients with out neurological history were used as control group. With mean transit time (MTT) image as a standard, the abnormal perfusion ranges were classified as region of interest (ROI),and the corresponding perfusion parameter values, including cerebral blood flow (CBF), cerebral blood volume (CBV), MTT and time to peak (TTP) were recorded,respectively. The cerebellum was used as a reference in this study, the perfusion parameters were standardized, and the relative ratios of the perfusion parameters(rMTT,rTTP,rCBF,rCBV) were obtained. Results:Compared with control group,the rMTT and rTTP of the patients in typical moyamoya disease group were prolonged and the rCBF was reduced (P<0.05 or P<0.01), but the rCBV had no obvious difference(P>0.05). ② Compared with the contralateral side, the rMTT and rTTP of the suffered side were prolonged,and the rCBF and rCBV were reduced (P<0.05 or P<0.01).Compared with chronic onset group,the rCBV and rCBF of the patients in acute onset group were reduced(P<0.05 or P<0.01),but the rMTT and rTTP had no statistically significant difference (P>0.05). There were no significant differences in all parameters between hemorrhagic moyamoya disease group and ischemia group(P>0.05). Conclusion: MR perfusion imaging can accurately evaluate the hemodynamic condition of moyamoya disease; MTT and TTP hve higher sensitivities than CBF and CBV. MR perfusion imaging can evaluate the compensation of collateral circulation of moyamoya disease and provide the objective basis for the clinician to select the proper surgical timing and the best operation methods.

Key words: moyamoya disease, magnetic resonance perfusion imaging, cerebral hemodynamics, collateral circulation