Influence of Different Vascular Reconstruction Methods on Cerebral Hemodynamics in Patients with Moyamoya Disease Based on MRI Perfusion Imaging Technology Evaluation
Objective To explore the influence of superficial temporal artery-middle cerebral artery branch anastomosis(STA-MCA)and encephalo-duro-myo-synangiosis(EDMS)and encephalo-duro-arterio-myo-synangiosis(EDAMS)on cerebral hemodynamics in the treatment of moyamoya disease based on MRI perfusion imaging technology(PWI).Methods 95 patients undergoing moyamoya disease surgery from September 2019 to September 2022 were selected,and they were diagnosed by CTA and DSA and planned to undergo vascular reconstruction.According to the different surgical methods,they were divided into STA-MCA+EDMS group(STA-MCA combined with EDMS,52 cases)and EDAMS group(EDAMS,43 cases).At 3 months after surgery,the clinical efficacy and complications of the two groups were evaluated.The vascular reconstruction effect was evaluated by external carotid arteriography,and the cerebral hemodynamics were measured by head MRI perfusion imaging.Results At 3 months after surgery,the significant remission rate and remission rate in STA-MCA+EDMS group with 57.59％and 90.38％were higher than 37.21％and 72.09％in EDAMS group(P＜0.05).The good rate of vascular reconstruction with 82.69％was higher than 62.79％in EDAMS group(P＜0.05).There were no statistical differences in the total incidence rates of postoperative complications and adverse prognosis events between groups(P＞0.05).The CBF and CBV of anterior cerebral artery in the two groups at 3 months after surgery were enhanced,and the MTT and TTP were shortened(P＜0.05),and the CBF and CBV were higher and the MTT and TTP were shorter in STA-MCA+EDMS group(P＜0.05).Conclusion PWI has a good evaluated value on cerebral hemodynamics in patients with moyamoya disease after vascular reconstruction.Compared with EDAMS,STA-MCA combined with EDMS can better promote the vascular reconstruction,improve the cerebral hemodynamics and relieve the disease condition,but there is no prominent advantage in the improvement of complications and prognosis.
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