OBJECTIVE The aim of this study was to clarify the relationship between ischaemic symptoms during the early postoperative period in patients with moyamoya disease and changes in the cerebellar asymmetry index (AI), a parameter used to quantitatively identify crossed cerebellar diaschisis (CCD). PATIENTS AND METHODS We analysed the data of 18 patients with moyamoya disease who underwent quantitative IMP-cerebral blood flow SPECT at least once during the follow-up period. Cerebellar AI scores were calculated using the CBF of the cerebellum calculated automatically from multiple slices of SPECT images with automated ROI setup software and categorized and statistically examined according to the presence or absence of ischaemic symptoms. RESULTS The cerebellar AI calculated from SPECT performed in the patients who presented with ischaemic symptoms was 0.094 ± 0.023 (mean ± SD), which was significantly elevated compared to the value of 0.013 ± 0.025 (mean ± SD) calculated from SPECT performed when the patients did not present with ischaemic symptoms (p < 0.0001). Limiting the time of SPECT to calculate the cerebellar AI to be compared to the acute phase within 2 weeks after surgery did not change this trend, and again, the cerebellar AI was statistically significantly elevated in the presence of ischaemic symptoms (0.094 ± 0.023 (mean ± SD)) compared to the AI in the absence of ischaemic symptoms (0.000081 ± 0.026 (mean ± SD)) (p = 0.0003). In patients who underwent quantitative SPECT in the acute phase during the first postoperative week, the cerebellar AI values calculated from the results of SPECT performed during the preoperative period as well as multiple times during postoperative period were followed over time in each case. The cerebellar AI increased in patients who presented with symptoms of ischaemia postoperatively but then tended to decrease reversibly and approach zero with the disappearance of symptoms of ischaemia. CONCLUSIONS Since the cerebellar AI reflects the symptom of ischaemia in patients with moyamoya disease, especially in the early stage after revascularization surgery, and is a parameter that improves with symptom improvement, it seems to be useful for understanding the state of cerebral blood flow after bypass surgery in patients with moyamoya disease.

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烟雾病患者术后早期缺血症状与小脑不对称指数变化的关系

目的 本研究的目的是阐明烟雾病患者术后早期缺血症状与小脑不对称指数 (AI) 变化之间的关系，小脑不对称指数 (AI) 是一种用于定量识别交叉小脑分离 (CCD) 的参数。患者和方法 我们分析了 18 名烟雾病患者的数据，这些患者在随访期间至少接受了一次定量 IMP-脑血流 SPECT。使用自动 ROI 设置软件从多个 SPECT 图像切片自动计算的小脑 CBF 计算小脑 AI 评分，并根据缺血症状的存在或不存在进行分类和统计检查。结果 对出现缺血症状的患者进行 SPECT 计算的小脑 AI 为 0.094 ± 0.023（均值 ± SD），与在患者进行 SPECT 时进行的 SPECT 计算的值 0.013 ± 0.025（均值 ± SD）相比显着升高。没有出现缺血症状（p < 0.0001）。将 SPECT 计算小脑 AI 的时间与手术后 2 周内的急性期进行比较并没有改变这一趋势，同样，在存在缺血症状的情况下，小脑 AI 在统计学上显着升高（0.094 ± 0.023（平均值） ± SD)) 与没有缺血症状的 AI (0.000081 ± 0.026 (mean ± SD)) (p = 0.0003) 相比。在术后第一周在急性期接受定量 SPECT 的患者中，根据术前和术后多次进行的 SPECT 结果计算出的小脑 AI 值随时间推移在每种情况下进行跟踪。术后出现缺血症状的患者小脑AI升高，但随着缺血症状的消失呈可逆性降低并趋于零。结论由于小脑AI反映了烟雾病患者的缺血症状，特别是在血运重建手术后的早期，并且是随着症状改善而改善的参数，它似乎有助于了解旁路术后脑血流状态烟雾病患者的手术。