Evaluation of Intracranial Hemodynamics and Vascular Reactivity in Moyamoya Disease by Transcranial Doppler Ultrasound

概要

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Hemodynamics were studied in 15 normal subjects and 9 patients with angiographically proven Moyamoya disease by transcranial Doppler ultrasound (TC2-64B) . Vascular reconstruction such as STA-MCA anastomosis, EMS, EDAS and DP were performed in 6 out of 9 patients. Two and 8 MHz probes were used for Intracranial arteries and superficial temporal arteries (STA) respectively. The most characteristic finding on cerebral arteries (MCA, ACA) was the significant decrease of flow velocity, although the decreased flow rate varied greatly from artery to artery. Decrease or absence of vascular reactivity to hypocapnia was characteristically seen in patients. Moreover, wave form of flow velocity of STA was transformed from external carotid artery pattern to internal carotid artery pattern. This change in flow pattern was more remarkably seen in cases with abundant transdural anastomosis. Postoperatively, flow velocity of STA increased dramatically and the flow pattern become similar to internal pattern. Although flow velocity of middle and anterior cerebral arteries increased in many cases, reactivity to hypocapnia still remained in a remarkably decreased state. Observation of these pre- and post-operative characteristic changes of flow velocity and vascular reactivity in patients with Moyamoya disease seemed to be quite useful for evaluation of the hemodynamics and should provide information for a follow- up study.
日本脳神経超音波学会の論文