Color Doppler ultrasonography in the evaluation of compensatory arteries in patients with moyamoya disease: combined with cerebral angiography

H.-W. Pan, L. Chen, H.-Q. Jiang, Z. Ye, Y. Wang, Y. Wang

Department of Ultrasound and Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China. dr_wy@189.cn

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• Neurology

OBJECTIVE: To evaluate the hemodynamics of maxillary artery (MA), superficial temporal artery (STA) and ophthalmic artery (OA), and evaluate the hemodynamics prediction capability of these arteries formed compensatory arteries into intracranial using Doppler ultrasonography.

PATIENTS AND METHODS: The evaluation of MA, STA, and OA with transcranial doppler ultrasonography and with cerebral angiography was made in 106 MMD patients (total of 212 hemispheres of the brain), 58 male and 48 female, aged 39.3±12.0 years old. Doppler ultrasonography measured the following blood flow parameters: peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI). DSA evaluate whether MA, STA, OA formed compensatory arteries into intracranial. Based on the compensation situation, the patients were divided into two groups: compensatory group and non-compensatory group. The differences of patient’s hemodynamic parameters between compensatory and non-compensatory groups were performed using independent two-sample t-tests with equal or non-equal variance as appropriate. Categorical variables were summarized using frequency and percentage and compared using Chi-square tests. We evaluated the prediction ability of each hemodynamic parameters for each artery (combining left and right side) using Receiver Operating Curve. All the analyses were performed using SAS 9.4 (Cary, NC).

RESULTS: Comparing the hemodynamic parameters between the compensatory group and non-compensatory group, all hemodynamic parameters of MA, STA and OA have statistically significant differences between the two groups. Depending on the ROC Curve, EDV (AUC=0.6933±0.0463) for MA, RI (AUC=0.8910±0.0569) for STA, EDV (AUC=0.7863± 0.0330) for OA are better predictors of compensatory growth.

CONCLUSIONS: Color duplex ultrasonography is a reliable, noninvasive and economic tool to assess hemodynamic changes of MA, STA and OA, and has prediction capability of these arteries formed compensatory arteries into intracranial.

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