• Xiaoqiang Wang, Zhen Chong, Xiang Guo, Deguo Liu, Zhanguo Sun, Yueqin Chen, Lingyun Gao, and Yuge Chen.
• Department of Medical Imaging, The Affiliated Hospital of Jining Medical University, Jining, China.
• World Neurosurg. 2019 Nov 1; 131: e277-e283.

ObjectiveTo explore the feasibility of computed tomography perfusion imaging (CTP) for evaluating hemodynamics in hemorrhagic moyamoya disease (MMD).MethodsThe retrospective analysis included 25 patients with hemorrhagic MMD who underwent brain CTP examination. Two experienced radiologists manually delineated regions of interest (ROIs) in the bilateral frontal lobe, temporal lobe, brain tissue adjacent to the hemorrhagic foci, and brainstem as a control region. The perfusion values for all ROIs were extracted, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP). Subsequently, the differences in perfusion values for different brain tissues were compared between the hemorrhagic side and the nonhemorrhagic side. For patients who underwent revascularization surgery, differences in perfusion values from before to after surgery were determined in brain tissues on the ipsilateral side.ResultsCBF in the area around the hematoma and the lateral temporal lobe on the hemorrhage hemisphere was lower than that on the contralateral side, whereas TTP and MTT were higher. Among the 14 patients who underwent revascularization, CBF and CBV in the postoperative temporal lobes were higher than the preoperative values, whereas TTP and MTT were lower. CBF and CBV in the frontal lobe were higher after the operation.ConclusionsHemorrhagic MMD results in cerebral ischemia, and CTP could be used to localize such ischemic brain tissue and objectively evaluate the changes in cerebral hemodynamics with revascularization.Copyright © 2019. Published by Elsevier Inc.

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