성인 모야모야병에 있어서 acetazolamide부하 관류 CT검사를 통한 뇌혈관 예비능의 정량분석: 혈관조영술 소견과 비교한 초기경험
Quantitative Cerebrovascular Reserve Measured by Acetazolamide-Challenged Dynamic CT Perfusion in Ischemic Adult Moyamoya Disease : Initial Experience with Angiographic Correlation
- 주제(키워드) Moyamoya disease , Cerebrovascular Reserve , CT Perfusion , Acetazolamide
- 발행기관 아주대학교
- 지도교수 김선용
- 발행년도 2009
- 학위수여년월 2009. 2
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000009432
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
CT perfusion is a much more readily accessible imaging method to assess cerebral hemodynamic status than single-photon emission CT. We prospectively assessed quantitative cerebrovascular reserve by using acetazolamide (ACZ)-challenged CT perfusion for evaluating hemodynamic impairment in ischemic adult Moyamoya disease and compared it with angiographic findings. Sixteen adult patients with ischemic Moyamoya disease and 12 age-matched normal control subjects underwent both ACZ-challenged CT perfusion and digital subtraction angiography. Normalized baseline hemodynamic parameters and their percent changes (PCs) were calculated in 56 hemispheres. We classified the degrees of distal carotid artery stenosis according to modified Suzuki stage and determined the presence of basal Moyamoya vessels (BMVs). The values of normalized parameters and their PCs were compared with angiographic findings. Normalized baseline mean transit time (MTT) and PC of normalized cerebral blood flow (CBF) were significantly correlated with angiographic stages in all of the vascular territories; however, the correlation coefficient of the normalized baseline MTT was lower than that of the PC of CBF. In the external borderzone and the middle cerebral arterial territory, the hemispheres with extensive BMVs exhibited significantly lower PC values of CBF and significantly higher normalized baseline MTT values than those in hemispheres with diminished BMVs and in normal control subjects. Among the hemodynamic parameters measured by ACZ-challenged CT perfusion, the PC of CBF correlated highly significantly with angiographic stage; however, the normalized baseline CT perfusion parameters showed weak or no significant correlation.
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ABSTRACT i
TABLE OF CONTENTS iii
LIST OF FIGURES iv
LIST OF TABLES v
I.INTRODUCTION 1
II. MATERIALS AND METHODS 3
A.MATERIALS 3
1. Study Patients 3
B.METHODS 4
1. CT Perfusion Imaging Protocol 4
2. CTP Data Processing 5
3. Data Analysis 6
4. Statistical analysis 7
III.RESULTS 12
IV.DISCUSSION 19
V.CONCLUSION 23
REFERENCES 24
국문요약 28
