Object Moyamoya disease (MMD) is a common and chronic progressive stenotic-occlusive cerebrovascular disease in Eastern Asia. To evaluate the hemispheric haemodynamic status of adult patients with MMD, we explored the potential risk factors of hemispheric perfusion alterations with CT perfusion (CTP) and DSA. Methods We retrospectively reviewed 44 male and 44 female (176 hemispheres) adult patients with MMD who had both DSA and CTP. Data on cerebral blood perfusion (CBF), cerebral blood volume (CBV), mean transmit time (MTT), time to peak (TTP) of cerebral hemisphere and cerebellum were gathered and difference of relative haemodynamic parameters between different subgroups were assessed with independent sample t analysis, one-way analysis of variance and general linear regression analysis. Results Parameters in regional CBF (rCBF) of frontal, temporal lobe and basal ganglia in female was more superior than male. rCBF, regional MTT (rMTT) and regional TTP (rTTP) in adult MMD patients with haemorrhage were superior than the ischaemic. With the increase of age, significant difference could be seen in rCBF and rCBV of thalamus. However, with progress of arterial stenosis, significant difference could only be obsevrved in rCBV, rMTT and rTTP, whereas rCBF had no significant difference. For increase of moyamoya vessels, significant decrease of rCBF could be seen in temporal and parietal lobe. With the increase of compensatory artery numbers, no significant difference could be seen in rCBF parameters (p>0.05). Conclusions In adult MMD patients, age, gender and clinical type were potential risk factors for the change of cerebral perfusion. When arterial stenosis is worsened, moyamoya vessels could alter perfusion of temporal and parietal lobe, but not frontal lobe. Extracranial/intracranial compensatory arteries could maintain microcirculation stability in frontal lobe and basal ganglia, indicating that the protection from extracranial compensatory arteries, a theoretic base for surgery treatment if necessary.

中文翻译：

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烟雾病成人患者的血流动力学分析：CT 灌注和 DSA 分级

对象烟雾病（MMD）是东亚地区常见的慢性进行性狭窄闭塞性脑血管疾病。为了评估成年 MMD 患者的半球血流动力学状态，我们探讨了 CT 灌注 (CTP) 和 DSA 导致半球灌注改变的潜在危险因素。方法 我们回顾性分析了 44 名男性和 44 名女性（176 个大脑半球）合并 DSA 和 CTP 的 MMD 成人患者。收集大脑半球和小脑的脑血流灌注（CBF）、脑血容量（CBV）、平均传递时间（MTT）、达峰时间（TTP）数据，并采用独立样本评估不同亚组之间相对血流动力学参数的差异t 分析、单因素方差分析和一般线性回归分析。结果 额叶区域 CBF (rCBF) 参数，女性颞叶和基底节优于男性。成人MMD出血患者的rCBF、区域MTT（rMTT）和区域TTP（rTTP）优于缺血。随着年龄的增长，丘脑的rCBF和rCBV存在显着差异。但随着动脉狭窄程度的进展，仅在rCBV、rMTT和rTTP中可观察到显着差异，而rCBF无显着差异。对于烟雾血管的增加，在颞叶和顶叶可以看到rCBF显着降低。随着代偿动脉数量的增加，rCBF参数无显着差异（p>0.05）。结论 在成年MMD患者中，年龄、性别和临床类型是脑灌注改变的潜在危险因素。当动脉狭窄加重时，烟雾血管可以改变颞叶和顶叶的灌注，但不能改变额叶。颅外/颅内代偿动脉可以维持额叶和基底节微循环的稳定，表明颅外代偿动脉的保护作用是必要时进行手术治疗的理论基础。