Adult Moyamoya disease: 320-multidetector row CT for evaluation of revascularization in STA-MCA bypasses surgery

Abstract

Purpose: To evaluate the utility of 320-multidetector row whole-brain computed tomography perfusion (WBCTP) and whole-head subtracted dynamic angiography (WHSDCTA) for assessing the revascularization of blood flow after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in adults with Moyamoya disease (MD) in the short and long term.

Patients and methods: 320-multidetector row WBCTP and WHSDCTA were applied in 20 patients with MD before and after surgery (for an average of 3 days and 3 months). The bypass arteries were investigated using WHSDCTA and compared with DSA. The regions of interests (ROIs) in the surgical and mirror sides of the cerebral cortex were drawn on a Vitrea Workstation. Cerebral blood volume (CBV), time to peak (TTP), cerebral blood flow (CBF), mean transit time (MTT), and delay time were recorded. Preoperative and postoperative perfusion parameters in the MCA distribution were compared using the paired t-test.

Results: WHSDCTA could clearly demonstrate 24 bypass arteries in 26 arteries for 20 patients, results which were in accordance with the results of digital subtraction angiography (DSA). When comparing preoperative values to those within 3 days after surgery, only TTP and delay time were significantly different (P<0.05). Values of CBV, TTP, CBF, delay time, and MTT 3 months after surgery were significantly different (P<0.05) from those of preoperative perfusion.

Conclusion: These data suggest that 320-multidetector row WBCTP and WHSDCTA can be used to evaluate the revascularization of blood flow after STA-MCA bypass surgery in patients with MD in the short and long term.

Keywords: 320-Multidetector row; CTP; MCA; Middle cerebral artery; Moyamoya disease; ROIs; STA; Superficial temporal artery; WBCTP; WHSDCTA; ct perfusion; middle cerebral artery; regions of interest, delay time is the relative arrival time of the contrast medium in tissue compared with the opposite hemisphere; superficial temporal artery; whole-brain computed tomography perfusion; whole-head subtracted dynamic angiography.