烟雾病围术期的影像学研究进展

摘要/Abstract

摘要：

【摘要】血管重建术是烟雾病的主要治疗方法，脑血管成像及脑灌注成像在血管重建术前评价血管和血流动力学状态、预测手术风险、术中实时监控、术后评价中发挥了重要作用。两者的结合应用既能显示血管的形态学变化，又能反映生理功能的改变，对围术期烟雾病患者的血管及灌注情况评估有重要作用。

文章导读： 本文对烟雾病围术期的脑血管成像及脑灌注成像研究进展进行综述，阐明其临床应用价值。

关键词: 烟雾病; 围术期; 影像学; 血管成像; 灌注成像

Abstract:

【Abstract】 Cerebral revascularization procedures are the main treatment of moyamoya disease. Cerebral angiography and perfusion imaging play an important role in the preoperative evaluations of vascular status and cerebral hemodynamics, surgical risk predictions, real-time intraoperative monitoring and postoperative evaluations. The combined application of cerebral angiography and perfusion, which not only reflects vascular morphological changes but also reflects physiology function, can provide critical information for the perioperative evaluations of vascular status and cerebral hemodynamics

Key words: Moyamoya disease; Perioperative period; Imaging, Angiography, Perfusion Imaging

张亚男1，高培毅2，薛静2. 烟雾病围术期的影像学研究进展[J]. 中国卒中杂志, 2013, 8(08): 674-679.

ZHANG Ya-Nan*, GAO Pei-Yi, XUE Jing.. Advances in Perioperative Imaging of Moyamoya Disease[J]. Chinese Journal of Stroke, 2013, 8(08): 674-679.

参考文献

1 谯飞, 游潮, 李浩, 等. 烟雾病的现状和最新认识[J]. 华西医学, 2012, 27:151-153.

2 Kleinloog R, Regli L, Rinkel GJ, et al. Regional differences in incidence and patient characteristics of moyamoya disease:a systematic review[J]. J Neurol Neurosurg Psychiatry, 2012, 83:531-536.

3 Takahashi JC, Miyamoto S. Moyamoya disease:recent progress and outlook[J]. Neurol Med Chir (Tokyo), 2010, 50:824-832.

4 Matsushima T, Inoue K, Kawashima M, et al. History of the development of surgical treatments for moyamoya disease[J]. Neurol Med Chir (Tokyo), 2012, 52:278-286.

5 Suzuki J, Takaku A. Cerebrovascular "moyamoya" disease. Disease showing abnormal net-like vessels in base of brain[J]. Arch Neurol, 1969, 20:288-299.

6 Houkin K, Yoshimoto T, Kuroda S, et al. Angiographic analysis of moyamoya disease--how does moyamoya disease progress[J]. Neurol Med Chir (Tokyo), 1996, 36:783-788.

7 Zaharchuk G, Do HM, Marks MP, et al. Arterial spin-labeling MRI can identify the presence and intensity of collateral perfusion in patients with moyamoya disease[J]. Stroke, 2011, 42:2485-2491.

8 Houkin K, Nakayama N, Kuroda S, et al. Novel magnetic resonance angiography stage grading for moyamoya disease[J]. Cerebrovasc Dis, 2005, 20:347-354.

9 施万印, 柏亚, 吴兴旺, 等. 烟雾病侧枝循环的MRI表现[J]. 中国临床医学影像杂志, 2006, 17:185-187.

10 Jayakumar PN, Vasudev MK, Srikanth SG. Posterior circulation abnormalities in moyamoya disease:a radiological study[J]. Neurol India, 1999, 47:112-117.

11 Yamada I, Himeno Y, Nagaoka T, et al. Moyamoya disease:evaluation with diffusion-weighted and perfusion echo-planar MR imaging[J]. Radiology, 1999, 212:340-347.

12 Sugino T, Mikami T, Ohtaki S, et al. Assessment of moyamoya disease using multidetector row computed tomography[J]. J Stroke Cerebrovasc, 2013, 22:644-649.

13 徐燕, 文亮, 韩丹, 等. 头颅双能CT血管造影与数字减影血管造影的对比分析[J]. 中国医学科学院学报, 2010, 32:699-703.

14 Matsumoto M, Kodama N, Endo Y, et al. Dynamic 3D-CT angiography[J]. AJNR Am J Neuroradiol, 2007, 28:299-304.

15 张亚男, 高培毅, 张东, 等. 能谱计算机断层扫描容积螺旋穿梭扫描技术在烟雾病中的初步应用研究[J]. 中国卒中杂志, 2013, 8:93-99.

16 刘兴炬, 张东, 王硕, 等. 手术与保守治疗烟雾病患者的单中心长期随访观察[J]. 中华医学杂志, 2012, 92:604-607.

17 Kuroda S, Ishikawa T, Houkin K, et al. Incidence and clinical features of disease progression in adult moyamoya disease[J]. Stroke, 2005, 36:2148-2153.

18 何毅华, 高聪, 解龙昌, 等. Suzuki分级及异常代偿血管与成人烟雾病脑出血及缺血的关系[J]. 山东医药, 2012, 52:8-10.

19 Liu W, Zhu S, Wang X, et al. Evaluation of angiographic changes of the anterior choroidal and posterior communicating arteries for predicting cerebrovascular lesions in adult moyamoya disease[J]. J Clin Neurosci, 2011, 18:374-378.

20 Lee M, Guzman R, Bell-Stephens T, et al. Intraoperative blood flow analysis of direct revascularization procedures in patients with moyamoya disease[J]. J Cereb Blood Flow Metab, 2011, 31:262-274.

21 Kaku Y, Watarai H, Kokuzawa J, et al. Less invasive technique for EC-IC bypass[J]. Acta Neurochir Suppl, 2008, 103:83-86.

22 Awano T, Sakatani K, Yokose N, et al. Intraoperative EC-IC bypass blood flow assessment with indocyanine green angiography in moyamoya and non-moyamoya ischemic stroke[J]. World Neurosurg, 2010, 73:668-674.

23 曹芳, 孙晓川. 烟雾病的直接血管重建术治疗进展[J]. 重庆医学, 2012, 41:2426-2429, 2340.

24 Robertson RL, Burrows PE, Barnes PD, et al. Angiographic changes after pial synangiosis in childhood moyamoya disease[J]. AJNR Am J Neuroradiol, 1997, 18:837-845.

25 Jin Q, Noguchi T, Irie H, et al. Assessment of Moyamoya disease with 3.0-T magnetic resonance angiography and magnetic resonance imaging versus conventional angiography[J]. Neurol Med Chir (Tokyo), 2011, 51:195-200.

26 陈谦, 黄伟. 灌注成像在烟雾病中的应用[J]. 国际脑血管病杂志, 2013, 21:117-121.

27 Ogawa A, Nakamura N, Sakurai Y, et al. Cerebral blood flow in moyamoya disease[J]. No To Shinkei, 1987, 39:199-203.

28 赵军, 林祥通. PET在神经系统疾病中的应用[J]. 中国临床神经科学, 2001, 3:304-309.

29 欧阳巧洪, 段中响, 段炼, 等. 18F-FDG脑PET显像评价烟雾病治疗效果的价值[J]. 中国临床医学影像杂志, 2009, 20:117-118.

30 Kashyap R, Mittal BR, Sunil HV, et al. 99mTc-ECD brain SPECT in patients with Moyamoya disease:A reflection of cerebral perfusion status at tissue level in the disease process[J]. Indian J Nucl Med, 2011, 26:82-85.

31 Bokkers RP, van Laar PJ, van de Ven KC, et al. Arterial spin-labeling MR imaging measurements of timing parameters in patients with a carotid artery occlusion[J]. AJNR Am J Neuroradiol, 2008, 29:1698-1703.

32 Tanaka Y, Nariai T, Nagaoka T, et al. Quantitative evaluation of cerebral hemodynamics in patients with moyamoya disease by dynamic susceptibility contrast magnetic resonance imaging--comparison with positron emission tomography[J]. J Cereb Blood Flow Metab, 2006, 26:291-300.

33 Kassner A, Zhu XP, Li KL, et al. Neoangiogenesis in association with moyamoya syndrome shown by estimation of relative recirculation based on dynamic contrast-enhanced MR images[J]. AJNR Am J Neuroradiol, 2003, 24:810-818.

34 高培毅. 脑梗死前期脑局部低灌注的CT灌注成像表现及分期[J]. 中国卒中杂志, 2008, 3:115-119.

35 张军, 王剑虹, 耿道颖, 等. 采用256层CT全脑灌注研究烟雾病术后桥血管再通及手术前后脑血流动力学的变化[J]. 中华放射学杂志, 2011, 45:743-746.

36 Rim NJ, Kim HS, Shin YS, et al. Which CT perfusion parameter best reflects cerebrovascular reserve?:correlation of acetazolamide-challenged CT perfusion with single-photon emission CT in Moyamoya patients[J]. AJNR Am J Neuroradiol, 2008, 29:1658-1663.

37 Fujimura M, Mugikura S, Shimizu H, et al. Diagnostic value of perfusion-weighted MRI for evaluating postoperative alteration of cerebral hemodynamics following STA-MCA anastomosis in patients with moyamoya disease[J]. No Shinkei Geka, 2006, 34:801-809.

38 McAuley DJ, Poskitt K, Steinbok P. Predicting stroke risk in pediatric moyamoya disease with xenon-enhanced computed tomography[J]. Neurosurgery, 2004, 55:327-332.

39 马潞娜, 张涛, 李立伟, 等. SPECT脑血流断层显像结合半定量指标对烟雾病血管重建术疗效评价作用[J]. 实用医学杂志, 2011, 5:809-811.

40 So Y, Lee HY, Kim SK, et al. Prediction of the clinical outcome of pediatric moyamoya disease with postoperative basal/acetazolamide stress brain perfusion SPECT after revascularization surgery[J]. Stroke, 2005, 36:1485-1489.

41 Fujimura M, Mugikura S, Shimizu H, et al. Diagnostic value of perfusion-weighted MRI for evaluating postoperative alteration of cerebral hemodynamics following STA-MCA anastomosis in patients with moyamoya disease[J]. No Shinkei Geka, 2006, 34:801-809.

42 Yun TJ, Cheon JE, Na DG, et al. Childhood moyamoya disease:quantitative evaluation of perfusion MR imaging--correlation with clinical outcome after revascularization surgery[J]. Radiology, 2009, 251:216-223.

43 Lee SK, Kim DI, Jeong EK, et al. Postoperative evaluation of moyamoya disease with perfusion-weighted MR imaging:initial experience[J]. AJNR Am J Neuroradiol, 2003, 24:741-747.

44 戴冬伟, 赵文元, 许奕, 等. 头颅CT灌注成像对烟雾病行间接血流重建术的疗效评价[J]. 中华脑血管病杂志, 2011, 3:210-215.

45 方毅, 杨伟中, 龙亚红, 等. SPECT脑血流灌注显像在儿童烟雾病诊断中的价值探讨[J]. 中华临床医师杂志, 2012, 11:3112-3113.

46 Togao O, Mihara F, Yoshiura T, et al. Cerebral hemodynamics in Moyamoya disease:correlation between perfusion-weighted MR imaging and cerebral angiography[J]. AJNR Am J Neuroradiol, 2006, 27:391-397.

47 Ogata T, Yasaka M, Inoue T, et al. The clinical features of adult unilateral moyamoya disease:does it have the same clinical characteristics as typical moyamoya disease?[J]. Cerebrovasc Dis, 2008, 26:244-229.

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