山东医药2025，Vol.65Issue(7)：32-36,5.DOI:10.3969/j.issn.1002-266X.2025.07.008
烟雾病患者行颞浅动脉-大脑中动脉搭桥术治疗前后脑灌注功能及脑白质微结构变化
Changes in cerebral perfusion function and microstructure of white matter before and after superficial temporal artery-middle cerebral artery bypass surgery in patients with moyamoya disease
摘要
Abstract
Objective To observe the changes in cerebral perfusion function and the microstructure of white matter before and after superficial temporal artery-middle cerebral artery bypass surgery in patients with moyamoya disease,aim-ing to evaluate the impact of the surgery on cerebral perfusion function and the integrity of white matter tracts,and provid-ing multimodal imaging evidence to support the efficacy of the procedure.Methods In this study,30 patients with moyamoya disease who underwent superficial temporal artery-middle cerebral artery bypass surgery were evaluated.Computed tomography perfusion(CTP)examinations were performed using a Philips 256-slice spiral CT scanner at four time points:1 week before surgery,and 1,3,and 6 months after the surgery.The peak time(TMAX)and cerebral blood flow(CBF)in the region of interest of the affected hemisphere were calculated to assess cerebral perfusion sta-tus.Additionally,Diffusion tensor imaging(DTI)examinations were conducted using a GE Signa Excite HDxt 3.0 T MR scanner to measure the fractional anisotropy(FA)values in the region of interest,and to evaluate the integrity of the white matter tracts.Results The results of the CTP examination one month after surgery showed that the TMAX value was lower than that measured one week before surgery(P<0.05).The CBF value at three months post-surgery was higher than that at one week before surgery,while the TMAX value was lower than that at one week before surgery(both P<0.05).At six months post-surgery,the CBF value was higher than those at one week before surgery,one month after surgery,and three months after surgery(all P<0.05).The TMAX value at six months post-surgery was lower than those at one week before surgery,one month after surgery,and three months after surgery(all P<0.05).The DTI examina-tion showed that the FA values at all time points were higher than those at one week before surgery,one month after sur-gery,and three months after surgery(all P<0.05).Correlation analysis indicated that,one week before surgery,the CBF was positively correlated with the FA value(ρ=0.45,P=0.01)and TMAX was negatively correlated with the FA value(ρ=-0.44,P=0.01)in patients with moyamoya disease.At six months post-surgery,CBF was positively correlat-ed with FA value(ρ=0.45,P=0.01)and TMAX was negatively correlated with FA value(ρ=-0.46,P=0.01)in these patients.Conclusions After undergoing superficial temporal artery-middle cerebral artery bypass surgery,pa-tients with moyamoya disease show improvement in cerebral perfusion function,and there is some recovery in the micro-structural damage of the white matter,with a correlation observed between the two.The period of 3 to 6 months post-sur-gery is critical for the restoration of cerebral perfusion function and the repair of white matter microstructure in patients with moyamoya disease.关键词
烟雾病/脑灌注功能/脑白质微结构/弥散张量成像/颅脑灌注扫描Key words
moyamoya disease/cerebral perfusion function/microstructure of white matter/diffusion tensor imag-ing/cerebral computed tomography perfusion分类
医药卫生引用本文复制引用
彭澳,刘希光,李爱民,徐进旺,徐德智,张乐,乔光念,陈鹏宇,寇艳,赵盼盼..烟雾病患者行颞浅动脉-大脑中动脉搭桥术治疗前后脑灌注功能及脑白质微结构变化[J].山东医药,2025,65(7):32-36,5.基金项目
江苏省卫生健康委医学科研项目面上项目(H2023145). （H2023145）
