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Postoperative Evaluation of Moyamoya Disease with Perfusion-Weighted MR Imaging: Initial Experience

Authors
 Seung-Koo Lee  ;  Dong Ik Kim  ;  Joong-Uhn Choi  ;  Dong-Seok Kim  ;  Yon Kwon In  ;  Sang Heum Kim  ;  Si-Yeon Kim  ;  Eun-Kee Jeong 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.24(4) : 741-747, 2003 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2003
MeSH
Adolescent ; Adult ; Blood Volume/physiology ; Brain/blood supply* ; Brain Ischemia/diagnosis ; Brain Ischemia/physiopathology ; Brain Ischemia/surgery* ; Cerebral Angiography ; Cerebral Revascularization* ; Child ; Child, Preschool ; Collateral Circulation/physiology ; Female ; Follow-Up Studies ; Humans ; Image Enhancement* ; Image Processing, Computer-Assisted* ; Male ; Moyamoya Disease/diagnosis ; Moyamoya Disease/physiopathology ; Moyamoya Disease/surgery* ; Postoperative Complications/diagnosis* ; Postoperative Complications/physiopathology ; Regional Blood Flow/physiology ; Tomography, Emission-Computed, Single-Photon
Keywords
12695215
Abstract
BACKGROUND AND PURPOSE: Encephaloduroarteriosynangiosis (EDAS) has become the main treatment for moyamoya disease, a chronically progressive cerebrovascular occlusive disease in children. We aimed to assess the utility of perfusion-weighted MR imaging for evaluating hemodynamic changes before and after EDAS. METHODS: Thirteen patients with angiographically confirmed moyamoya disease who underwent EDAS were investigated, and results were compared with those of a control group (n = 5). Perfusion MR imaging was performed before and after EDAS by using a T2*-weighted contrast material-enhanced technique. Relative cerebral blood volume (rCBV) and time to peak enhancement (TTP) maps were calculated. Relative ratios of rCBV and TTP in the middle cerebral artery (MCA) and basal ganglia were measured and compared with those of the posterior cerebral artery (PCA). Changes in hemodynamic parameters between pre- and post-EDAS perfusion maps were investigated. RESULTS: The mean rCBV ratio of MCA to PCA in the patient group was slightly higher than that in the control group, without statistical significance. All 13 patients showed a delayed TTP in the MCA before EDAS compared with the control group (P =.0006), and the TTP after EDAS was significantly reduced (P =.0002). In the basal ganglia, shortening of the TTP was demonstrated before EDAS, but no significant change was observed after EDAS. CONCLUSION: Perfusion-weighted MR imaging can be applied for evaluating postoperative changes in cerebral blood flow in moyamoya disease. Shortening of the TTP in the MCA of the hemisphere operated on is a marker for the development of collateral circulation from the external carotid artery to the internal carotid artery.
Files in This Item:
T200305886.pdf Download
DOI
OAK-2003-01073
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114233
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