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Changing Ischemic Lesion Patterns and Hemodynamics of the Posterior Cerebral Artery in Moyamoya Disease
Author(s) -
Wang JingZhe,
He Wen,
Zhang Dong,
Yu LeBao,
Zhao YaHui,
Cai JinXiu
Publication year - 2019
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14959
Subject(s) - medicine , moyamoya disease , posterior cerebral artery , digital subtraction angiography , hemodynamics , perfusion , nuclear medicine , lesion , anterior cerebral artery , occlusion , cerebral arteries , middle cerebral artery , angiography , radiology , cardiology , ischemia , surgery
Objective The aim of this study was to determine how hemodynamics of the posterior cerebral artery (PCA) are associated with cerebral ischemic lesions in moyamoya disease (MMD). Methods Thirty‐six patients with ischemic MMD (Suzuki grade IV–V) were retrospectively analyzed. Hemodynamic parameters of the PCA were measured by transcranial color‐coded sonography. We classified the range of ischemic lesions into 3 grades and perfusion levels into 3 grades according to computed tomography (CT) results. PCA steno‐occlusion and leptomeningeal collaterals were confirmed by digital subtraction angiography. Ultrasonographic parameters in the PCA were compared with these radiographic findings. Results The velocity in the involved PCA (mean flow velocity [MFV] median, 42.00 [range, 34.50–58.00] cm/s) was significantly lower than that in the normal PCA (MFV median, 95.00 [range, 76.50–119.50] cm/s) ( P < .001). The velocity in the PCA increased significantly as the leptomeningeal collateral stage advanced (MFV stage 1: median, 38.50 [range, 29.75–63.50] cm/s; stage 2: median, 55.00 [range, 44.00–96.00] cm/s; stage 3: median, 94.00 [range, 54.00–118.25] cm/s; stage 4: median, 85.50 [range, 70.50–117.75] cm/s, respectively) ( P < .05). Decreased PCA velocities were associated with a larger ischemic area on CT ( P ≤ .001). PCA velocity had no correlation with CT perfusion level of the temporal and frontal lobes. PCA velocity had significant correlations with perfusion level in the occipital ( P < .001) and parietal lobes ( P < .05). Conclusions Our results suggest ischemic lesion patterns (as demonstrated on CT imaging) are associated with PCA velocity measurements in the advanced stage of MMD. Thus, monitoring PCA velocity in patients with advanced MMD may provide additional information to assist in managing these patients.