Jun Zhang MD, Presenter: Nothing to Disclose

Daoying Geng, Abstract Co-Author: Nothing to Disclose

To evaluate the feasibility of 256-slice whole-brain CT perfusion (CTP) in confirming the graft patency  as well as investigating cerebral hemodynamics changes in Momymoy disease before and after surgical revascularization

Seventy-eight cases in 39 subjects with Moyamoya disease were evaluated with 256-slice CT. CTP was performed pre- and post- surgical revascularization. The  4D-CTA and whole-brain perfusion images were obtained. Perfusion CT values (CBF, CBV, TTP and MTT) of ipsilateral lesion in the region of middle cerebral artery and contralateral mirroring areas of abnormal perfusion in functional maps were measured and relative CBF (rCBF), relative CBV (rCBV), relative TTP (rTTP), relative MTT (rMTT) were obtained. Differences in perfusion CT values pre- and post operation were assessed with the paired t test.

The stenosis and occlusion of multiple cerebral vessels can be well demonstraled on CTA and was similar to DSA.No significant differences between volumetric CTA and conventional CTA; All the direct graft patencies were displayed by volumetric CTA.Pre-operative CBF,MTT and TTPof ipsilateral lesion were significantly different from those of contralateral side(P<0.01 for all).Postoperative CBF, rCBF and rCBV values of ipsilateral lesion in the region of middle cerebral artery were significantly higher than those before operation (P<0.01 for all). Postoperative MTT, TTP, rMTT and rTTP values of ipsilateral lesion in the region of middle cerebral artery were significantly lower than those before operation (P<0.01,P<0.05,P<0.05,P<0.01 ; respectively). However, no significant difference was detected for changes of CBV after revascularization (P>0.05).

The 256-slice whole-brain CTP and 4D-CTA have the potential for the non-invasive assessment of the abnormalities of intracranial arteries, the graft patency and cerebral hemodynamics changes in moyamoya disease before and after surgery.

The whole-brain CTP can demostrate  the abnormalities of intracranial arteries,the graft  and cerebral hemodynamics changes and is recommended as part of a CT study before and after revascularization.

Zhang, J, Geng, D, 256-slice Whole-Brain CT Perfusion and 4D-CT Angiography Assessment in Moyamoya Disease before and after Surgical Revascularization.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034356.html