基于ASPECTS分区的烟雾病CT灌注与DSA侧支代偿的相关性研究OA北大核心CSTPCD

Objective To explore the correlation between CT perfusion and DSA collateral compensation and the risk factors affecting cerebral hemisphere perfusion in patients with Moyamoya disease. Methods A total of 115 adult Moyamoya disease patients with 230 cerebral hemispheres were enrolled in this study,and their DSA and CT perfusion data were collected.The ASPECTS was used to divide the brain regions and score four perfusion hemodynamic indicators including time to peak(TTP),mean transit time(MTT),cerebral blood flow(CBF),and cerebral blood volume(CBV),and to score the cerebrovascular collateral compensation displayed by DSA.Spearman correlation analysis and multiple linear regression analysis were performed on the four perfusion hemodynamic indicators and the DSA collateral compensation score. Results In 115 patients with Moyamoya disease,MTT score(r=0.41,P＜0.01)was positively correlated with the DSA collateral compensation score.The DSA collateral compensation score(β=0.31,P=0.02),gender(β=1.20,P=0.01),clinical type(β=2.94,P＜0.01),and history of stroke(β=-1.19,P=0.02)were independent influencing factors for cerebral perfusion changes.Female patients had better perfusion than male patients(P=0.02),hemorrhagic patients had better perfusion than ischemic patients(P=0.01),and patients without a history of stroke had better perfusion than those with a history of stroke(P=0.03). Conclusions The DSA collateral compensation score was correlated with the MTT score.Moreover,the DSA collateral compensation score,gender,clinical type,and history of stroke were independent influencing factors for cerebral hemisphere perfusion.CT perfusion should be considered when evaluating bypass vessels,neovascularization,and postoperative prognosis.