Objective To assess the curative effect of cerebral internal and external vascular bypass graft in patients with single middle cerebral artery(MCA) stenosis or occlusion by combining 64-row CT cerebral perfusion(CTP) with angiography(CTA). Methods Patients with middle cerebral artery stenosis or occlusion were recruited and underwent superficial temporal artery and middle cerebral artery(STA-MCA) bypass graft between March 2009 and Mar 2011. CTP and CTA examinations were performed in all patients before and after operation. The cerebral perfusion parameters were analyzed quantitatively and qualitatively. The origin, travel and anastomotic stoma of bypass grafts were evaluated by reconstructed CTA images. Results 46 patients were found with severe MCA stenosis or occlusion. The time to peak (TTP) and relative mean transit time(rMTT) images before therapy displayed the existence of perfusion delay. The relative cerebral blood flow (rCBF) and relative cerebral blood volume(rCRV) images did not change significantly. The decrease of TTP and rMTT after therapy was of statistical significance（P0.05）. In reconstructed CTA images, 82 bridge vessels were well displayed, including double bridges in 39 patients. The accuracy of CTA examination was 96.5%. All the bypass grafts were well shown and the anastomotic stomas were unobstructed. Conclusions It is feasible to evaluate the curative effects of cerebral internal and external vascular bypass graft by combining CTP images of cerebral perfusion after therapy with CTA images of cerebral internal and external bypass grafts.
Key words
middle cerebral artery /
stenosis or occlusion /
CT perfusion /
CT angiography
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