Evaluating regional cerebral blood flow in posterior circulation of patients with moyamoya disease using probabilistic map

초록

1264 Objectives Some patients with moyamoya disease(MMD) have involvement in the posterior cerebral artery(PCA). In this study, we evaluated the usefulness of probabilistic map(PMAP) analysis in evaluating the posterior circulation by comparing with the results of angiography. Methods 25 patients with MMD were enrolled in this study(M:F=7:18, Age=15.1±11.6 years). Each patient underwent acetazolamide-stressed brain perfusion SPECT, and TFCA(Mild stenosis: 8, Moderate: 7, Severe or Occlusion: 10). Each patient’s SPECT images were spatially normalized to Korean template with the SPM2. The pons count was used as a reference for regional count normalization. The SPECT images of patients were compared with normal control. The extent of decreased basal/acetazolamide perfusion in PCA territory were evaluated with PMAP. Results The four of eight patients with mild stenosis had not decreased basal/acetazolamide perfusion in the PCA territory. All patients with moderate-severe stenosis or occlusion had decreased basal/acetazolamide perfusion in PCA territory. The four of total patients had MMD involvement in unilateral PCA or mild stenosis. However, in the PMAP analysis they had decreased acetazolamide perfusion in bilateral PCA territory. Furthermore, they had MMD involvement in the contralateral PCA in follow-up. Conclusions With the PMAP of PCA territory, we could accurately evaluate the posterior circulation. The PMAP of the PCA territory was useful to evaluate the posterior circulation in patient with MMD. The PMAP analysis has a complementary role to angiography.