Change in brain perfusion after extracranial-intracranial bypass surgery detected using the mean transit time of computed tomography perfusion

Michael Mu Huo Teng*, Sen Li Jen, Fang Ying Chiu, Yi Hsuan Kao, Chung Jung Lin, Feng Chi Chang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Cerebral perfusion can be evaluated using a computed tomography (CT) scan by intravenous bolus injection of contrast media. The purpose of this study was to investigate the value of CT perfusion (CTP) in follow-up of extracranial-intracranial (EC-IC) bypass surgery. Methods: We retrospectively reviewed pre- and postoperative CTP studies in 14 patients who received EC-IC bypass surgery because of cerebral arterial occlusion or stenosis. Brain areas showing prolongation of the mean transit time (MTT) were automatically identified and quantitatively measured. Results: All 14 patients showed MTT prolongation in the preoperative CTP study. In 13 patients, a reduction in brain volume with MTT prolongation was noted during postoperative CTP. These 13 patients had a patent EC-IC anastomosis, and 42 ± 21% of the brain area with MTT prolongation returned to normal MTT during CTP 7 ± 4 days (range 2-13 days) after surgery. On clinical follow up of 41 ± 16 months (range 14-60 months), no stroke or transient ischemic attack was noted after bypass surgery in these 13 patients. The brain volume with MTT prolongation did not decrease in just one patient whose EC-IC anastomosis was not patent, and the patient suffered a minor stroke during surgery. Conclusion: Quantitative results for the brain area with MTT prolongation were positively correlated with improvement in brain perfusion shown on MTT, EC-IC bypass patency, and patient outcome.

Original languageEnglish
Pages (from-to)649-653
Number of pages5
JournalJournal of the Chinese Medical Association
Volume75
Issue number12
DOIs
StatePublished - Dec 2012

Keywords

  • Brain perfusion
  • CT perfusion
  • Extracranial-intracranial (EC-IC) bypass
  • Mean transit time
  • Superficial temporal-middle cerebral anastomosis

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