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
PENG Ao
LI Aimin
XU Jinwang
XU Dezhi
ZHANG Le
QIAO Guangnian
CHEN Pengyu
KOU Yan
ZHAO Panpan
LIU Xiguang
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.
Keywords：moyamoya diseasecerebral perfusion functionmicrostructure of white matterdiffusion tensor imag-ingcerebral computed tomography perfusion
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 32-36 )