Clinical Prediction of Surgical Revascularization Outcome in Moyamoya Disease Via Transcranial Color Sonography

Abstract Objective Transcranial color-duplex sonography (TCCS) is a promising method in evaluating the hemodynamics in patients with moyamoya disease (MMD). This study aimed to explore the feasibility of preoperative TCCS in predicting the outcome of revascularization surgery in MMD patients. Methods We retrospectively analysed 64 cases of MMD patients receiving revascularization surgery from January 2012 to January 2014. We utilized TCCS to perform comprehensive hemodynamic examination on the hemodynamics of bilateral intracranial and extracranial cerebrovascular flow and assessed the surgical outcomes and prognosis through the longitudinal comparison of the preoperative and postoperative cerebrovascular hemodynamics. Occurrence of bypass blockage was regarded as surgical failure. Results We established a prediction model for bypass blockage among MMD patients with an AUC of 0.858 (95% CI: 0.666-1). The parameters, EDV of ECA and PSV of MA obtained by the model are the main preoperative predictors for bypass blockage. Conclusions TCCS could preoperatively determine the degree of MMD and evaluate the outcome of revascularization surgery. It also is a feasible tool to predict the curative effect by providing preoperative hemodynamic information.