Computed tomography perfusion study and neuropsychological assessments in moyamoya disease

Abstract

Abstract

“Computed Tomography Perfusion Study and Neuropsychological Assessments in Moyamoya Disease”

Moyamoya disease (MMD) is an idiopathic, progressive, non-atherosclerotic, non-inflammatory steno-occlusive cerebrovascular disease affecting the internal carotid arteries (ICAs) and their branches. ICA occlusion is associated with formation of abnormal, fragile collaterals. Anastomotic surgery is considered to be the most effective treatment for MMD. Nevertheless, the superficial temporal artery-middle cerebral artery anastomosis may be complicated by symptomatic cerebral hyperperfusion (SCH). SCH may cause brain tissue edema and cognitive dysfunction.

The present study aimed at evaluating the cognitive function of MMD patients with neuropsychological assessments and exploring the role of SCH.

Computed tomography (CT) is a computerized x-ray imaging technique. Using developed software, time-based evaluation of the appearance and distribution of injected contrast allows evaluation of the passage of blood within brain tissue. CT perfusion (CTP) was performed before and after bypass surgery in MMD patients. The present study was also aimed at calculating cerebral blood volume (CBV) on a personal computer (PC) terminal instead of a CT workstation.

Clinical information, Neurobehavioral Cognitive Status Examination (NCSE), CT and CTP data were obtained from 18 adult Chinese MMD patients. Clinical and neuropsychological data were analyzed using SPSS, and the CT data were processed by ImageJ and MATLAB.

The present results revealed that NCSE could detect the cognitive function before and after the bypass surgery for identifying and estimating the occurrence of SCH. In addition, the CTP maps could indicate the dynamic status before and after surgery with CBV shown on a PC terminal.

In summary, the present thesis described the application and analysis of neuropsychological assessments and CTP in MMD patients. It is concluded that NCSE could be used as a fast, easy and sensitive method for detecting the MMD patients’ cognitive functions. Furthermore, a novel processing of CTP data could allow evaluation of their perfusion status.