Changes in Perfusion Computed Tomography after Conventional Extra‑ Intracranial Bypass Surgery

Czech version

Authors: M. Sameš ¹; T. Radovnický ¹; A. Zolal ¹; M. Nováková ²; M. Derner ²; P. Vachata ¹; R. Bartoš ¹
Authors‘ workplace: Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z. Neurochirurgická klinika Univerzity J. E. Purkyně ¹; Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z. Radiodiagnostické odd. ²
Published in: Cesk Slov Neurol N 2010; 73/106(3): 267-273
Category: Original Paper

Overview

Aim:
The aim of this study was to evaluate the perfusion parameters acquired by perfusion computed tomography (CT) examination of patients after extra- intracranial (EC- IC) bypass surgery. Patients and methods: The set consisted of 14 patients who underwent conventional bypass surgery at our department during the years 2005– 2008. In all patients, perfusion CT was performed before and after surgery and perfusion magnetic resonance after surgery. The results of the measurements of specific perfusion parameters were compared and the statistical significance of pre‑ and postoperative differences was evaluated. Results: After the EC- IC bypass surgery, reconstitution of cerebrovascular reserve capacity (CVRC) was achieved, according to the perfusion CT results, in all but one of the patients. A significant difference (p = 0.001) of the change index of cerebral blood flow (at rest/ in stress conditions) in pre‑operative and postoperative examinations was found using the paired T- test. However, there was no significant difference between pre‑ and postoperative cerebral blood flow values at rest. A significant (p <0.05) difference was found between pre‑operative and postoperative time to peak (TTP) values at rest, and also a borderline significant difference of TTP change index (p = 0.049). Conclusion: A significant improvement in CVRC after EC- IC bypass surgery was confirmed in patients with preoperative deficit, using the perfusion CT examination.

Key words:
perfusion computed tomography – extra-intracranial bypass – cerebrovascular reserve capacity

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