双源CT血管成像评价颅内外血管重建术治疗烟雾病

目的探讨双源CTA(DSCTA)在颅内外血管重建术治疗烟雾病(MMD)术前及术后评估中的应用价值。方法回顾性分析35例接受颅内外血管重建术的MMD患者,共37条搭桥血管。术前1周内行DSCTA及DSA评估颞浅动脉,术后1周复查DSCTA随访搭桥血管通畅性;对其中11例患者的12条搭桥血管于术后3~6个月内再次行DSCTA检查。由2名影像医师术前以3分法(优秀、良好、差)对DSCTA显示颞浅动脉进行评分,术后以5分法对搭桥血管通畅性进行评分。结果术前37条颞浅动脉均通畅,DSCTA显示为优秀32条(32/37,86.49%),良好5条(5/37,13.51%)。术后1周搭桥血管平均通畅性评分为2.95±1.05,通畅率为64.86%(24/37),术后6个月平均通畅性评分(3.75±0.97)及通畅率(11/12,91.67%)均较术后1周有所提高。结论 DSCTA在颅内外血管重建术治疗MMD的术前评估及术后随访中具有高度临床应用价值。

Dual-source CTA in pre- and post-operative assessment of extracranial-intracranial bypass in patients with Moyamoya disease

Objective To observe the value of dual-source CTA （DSCTA） for pre-and postoperative assessment of extracranial-intracranial bypass in patients with Moyamoya disease （MMD）. Methods A consecutive series of 35 MMD patients were retrospectively analyzed, and 37 superficial temporal artery （STA） were enrolled. Both DSCTA and DSA for STA were performed 1 week before surgical operation. DSCTA was initially performed within I week after surgery to as- sess the bypass patency, and then performed in 11 patients for 12 STA 3--6 months postoperatively for follow-up. Images were observed by two radiologists independently. Image quality of STA was evaluated using 3-score scale （good, moderate and poor）, while the quality of bypass visualization was evaluated using 5-score scale. Results Preoperative image quality of DSCTA for STA was good （32/37, 86.49%） or moderate （5/37, 13.51%）, the mean score of bypass visualization and the patency rate in the immediate postoperative period was 2.95±1.05 and 64.86 % （24/37）, respectively. The quality of 12 bypass visualization （3.75±0.97） and the patency rate （11/12, 91.67%） were all improved during the follow-up period. Conclusion DSCTA is an effective, non-invasive tool for preoperative planning and postoperative follow-up of extracra- nial-intracranial bypass surgery in patients with Moyamoya disease.