Affiliation:
1. Department of Radiology Stanford University Stanford California USA
2. Department of Neuroradiology Hospital Beatriz Ângelo Lisbon Portugal
3. Department of Neurosurgery Stanford University Stanford California USA
Abstract
BackgroundCerebrovascular reserve (CVR) reflects the capacity of cerebral blood flow (CBF) to change following a vasodilation challenge. Decreased CVR is associated with a higher stroke risk in patients with cerebrovascular diseases. While revascularization can improve CVR and reduce this risk in adult patients with vasculopathy such as those with Moyamoya disease, its impact on hemodynamics in pediatric patients remains to be elucidated. Arterial spin labeling (ASL) is a quantitative MRI technique that can measure CBF, CVR, and arterial transit time (ATT) non‐invasively.PurposeTo investigate the short‐ and long‐term changes in hemodynamics after bypass surgeries in patients with Moyamoya disease.Study TypeLongitudinal.PopulationForty‐six patients (11 months–18 years, 28 females) with Moyamoya disease.Field Strength/Sequence3‐T, single‐ and multi‐delay ASL, T1‐weighted, T2‐FLAIR, 3D MRA.AssessmentImaging was performed 2 weeks before and 1 week and 6 months after surgical intervention. Acetazolamide was employed to induce vasodilation during the imaging procedure. CBF and ATT were measured by fitting the ASL data to the general kinetic model. CVR was computed as the percentage change in CBF. The mean CBF, ATT, and CVR values were measured in the regions affected by vasculopathy.Statistical TestsPre‐ and post‐revascularization CVR, CBF, and ATT were compared for different regions of the brain. P‐values <0.05 were considered statistically significant.ResultsASL‐derived CBF in flow territories affected by vasculopathy significantly increased after bypass by 41 ± 31% within a week. At 6 months, CBF significantly increased by 51 ± 34%, CVR increased by 68 ± 33%, and ATT was significantly reduced by 6.6 ± 2.9%.Data ConclusionThere may be short‐ and long‐term improvement in the hemodynamic parameters of pediatric Moyamoya patients after bypass surgery.Evidence Level4Technical EfficacyStage 2
Funder
American Heart Association
National Institutes of Health
Subject
Radiology, Nuclear Medicine and imaging
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献