Arterial spin-labeling MR imaging in moyamoya disease compared with SPECT imaging

Noguchi, Tomoyuki; Kawashima, Masatou; Irié, Hiroyuki; Ootsuka, T.; Nishihara, Masashi; Matsushima, Toshio; Kudo, Sho

doi:10.1016/j.ejrad.2011.01.016

Cited by 81 publications

(59 citation statements)

References 24 publications

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“…In addition, several previous studies reported that measured CBF values were similar between ASL and SPECT and between ASL and DSC MR imaging in patients with Moyamoya disease or carotid stenosis. 24,37,38 According to these results, the sensitivity of ASL might be greater than that of SPECT for assessing cerebral perfusion during follow-up in patients with CCD and correlating the findings with the clinical course. Therefore, additional study using ASL is necessary to investigate the serial changes in CCD and their clinical importance.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 In contrast to DSC contrast MR perfusion imaging, PET, and SPECT, ASL imaging is a completely noninvasive method that does not require the injection of exogenous material such as gadolinium-based contrast or radioisotopes. In addition, CBF values derived by using ASL have been shown to correlate with those of SPECT in patients with Moyamoya disease 24 and with those of PET in patients with symptomatic ICA occlusion. 25 Although the results of a recent study suggested that CCD can be detected via ASL MR imaging, this finding was not validated against a reference method.…”

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confidence: 99%

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Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Kang

Sohn

Kim

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Crossed cerebellar diaschisis, not only a secondary result of supratentorial infarction but also an indicator of clinical outcomes, has frequently been reported on PET and SPECT but has been rarely described with arterial spin-labeling MR imaging. The purpose of this study was to determine the ability of arterial spin-labeling MR imaging to evaluate crossed cerebellar diaschisis compared with that of SPECT. To our knowledge, this is the first study to validate arterial spin-labeling in crossed cerebellar diaschisis by using SPECT as a reference standard.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Kang

Sohn

Kim

et al. 2015

AJNR Am J Neuroradiol

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“…The longitudinal magnetization of water in arterial blood is electromagnetically tagged with radiofrequency pulses and after a predefined transit time, the amount of labelled blood arriving in the tissue of interest is calculated by subtraction from a previously acquired control image [7]. Cerebral blood flow measurements using ASL have been shown to correlate with those of single-photon emission CT (SPECT) in patients with moyamoya disease [10] and with positron emission tomography (PET) in patients with symptomatic carotid artery occlusion [11].…”

Section: Dynamic Susceptibility Contrast Imaging (Dsc) Is the Currentmentioning

confidence: 99%

Arterial spin labelling MRI for assessment of cerebral perfusion in children with moyamoya disease: comparison with dynamic susceptibility contrast MRI

et al. 2013

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INTRODUCTION:This study seeks to evaluate the diagnostic accuracy of cerebral perfusion imaging with arterial spin labelling (ASL) MR imaging in children with moyamoya disease compared to dynamic susceptibility contrast (DSC) imaging. METHODS: Ten children (7 females; age, 9.2 ± 5.4 years) with moyamoya disease underwent cerebral perfusion imaging with ASL and DSC on a 3-T MRI scanner in the same session. Cerebral perfusion images were acquired with ASL (pulsed continuous 3D ASL sequence, 32 axial slices, TR = 5.5 s, TE = 25 ms, FOV = 24 cm, matrix = 128 × 128) and DSC (gradient echo EPI sequence, 35 volumes of 28 axial slices, TR = 2,000 ms, TE = 36 ms, FOV = 24 cm, matrix = 96 × 96, 0.2 ml/kg Gd-DOTA). Cerebral blood flow maps were generated. ASL and DSC images were qualitatively assessed regarding perfusion of left and right ACA, MCA, and PCA territories by two independent readers using a 3-point-Likert scale and quantitative relative cerebral blood flow (rCBF) was calculated. Correlation between ASL and DSC for qualitative and quantitative assessment and the accuracy of ASL for the detection of reduced perfusion per territory with DSC serving as the standard of reference were calculated. RESULTS: With a good interreader agreement ( = 0.62) qualitative perfusion assessment with ASL and DSC showed a strong and significant correlation ( = 0.77; p < 0.001), as did quantitative rCBF (r = 0.79; p < 0.001). ASL showed a sensitivity, specificity and accuracy of 94 %, 93 %, and 93 % for the detection of reduced perfusion per territory. CONCLUSION: In children with moyamoya disease, unenhanced ASL enables the detection of reduced perfusion per vascular territory with a good accuracy compared to contrast-enhanced DSC. Methods: 10 children (7 females, age: 9.2±5.4years) with moyamoya disease underwent cerebral perfusion imaging with ASL and DSC on a 3T MRI scanner in the same session.Cerebral perfusion images were acquired with ASL (pulsed continuous 3D ASL sequence, 32 axial slices, TR=5.5s, TE=25ms, FOV=24cm, matrix=128x128) and DSC (gradient echo EPI sequence, 35 volumes of 28 axial slices, TR=2000ms, TE=36ms, FOV=24cm, matrix=96x96, 0.2ml/kg Gd-DOTA). Cerebral blood flow maps were generated. ASL and DSC images were qualitatively assessed regarding perfusion of left and right ACA, MCA and PCA territories by two independent readers using a 3-point-Likert scale and quantitative relative cerebral blood flow (rCBF) was calculated. Correlation between ASL and DSC for qualitative and quantitative assessment and the accuracy of ASL for the detection of reduced perfusion per territory with DSC serving as the standard of reference were calculated.Results: With a good interreader agreement (k=0.62) qualitative perfusion assessment with ASL and DSC showed a strong and significant correlation (ρ = 0.77; p<0.001), as did quantitative rCBF (r=0.79; p<0.001). ASL showed a sensitivity, specificity and accuracy of 94%, 93% and 93% for the detection of reduced perfusion per territory. Conclusion:In children with moyamoya dis...

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“…Arterial spin labeling MRI has been compared with SPECT imaging in MMD, and a strong correlation has been found between arterial spin labeling value and ACZ-IMP value with SPECT, suggesting that perfusion imaging with arterial spin labeling MRI could show potentially dangerous zones for ischemia. 24 Cerebrovascular reactivity as measured by blood oxygen level-dependent MRI has also been shown to have a direct correlation with impaired vascular supply as measured by modified Suzuki score on angiography. 25 Quantitative MR angiography with NOVA software can show actual blood flow across large intracranial vessels and also flow across the superficial temporal artery after revascularization.…”

Section: Imagingmentioning

confidence: 99%

Neurosurgical Advances in the Treatment of Moyamoya Disease

Pandey

Steinberg

2011

Stroke

134

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Background and Purpose-Moyamoya disease is characterized by chronic stenoocclusive vasculopathy involving the distal supraclinoid internal carotid arteries and presents with ischemic or hemorrhagic symptoms. We review advances in the understanding and management of moyamoya disease. Summary of Review-Cerebral revascularization, either direct or indirect, is the cornerstone of treatment for moyamoya disease. Recent advances have been made in understanding the molecular biology and pathophysiology of moyamoya disease, and new genetic mutations and deletions have been identified. Imaging for moyamoya disease is also rapidly improving with new sequences of MRI and better methods of assessing ischemia and cerebrovascular reserve. Positron emission tomography has emerged as an important tool to measure cerebrovascular reserve. Novel surgical techniques assess patency and ischemia during superficial temporal to middle cerebral artery bypass, including indocyanine green videoangiography to evaluate anastomosis patency, and various methods to monitor intraoperative blood flow. Newer methods of indirect revascularization have been described with placement of more tissues supplied by the external carotid artery on the brain surface. Postoperative hyperperfusion to the chronically ischemic brain tissue is a recently identified causative factor of complications. Interestingly, complications from hyperperfusion mimic those caused by ischemia, although they have different treatments, making the role of postoperative blood flow assessment important in distinguishing between the two. Awareness has also increased that even asymptomatic patients can experience significant cognitive decline attributable to chronic ischemia. Whether this reverts after successful revascularization requires investigation. Conclusions-Surgical revascularization with direct, indirect, and combined methods remains the preferred procedure for patients with moyamoya disease. (Stroke. 2011;42:3304-3310.)Key Words: moyamoya disease Ⅲ revascularization Ⅲ STA-MCA bypass M oyamoya disease (MMD) is a chronic, progressive disease characterized by stenosis or occlusion of the bilateral supraclinoid internal carotid arteries along with development of leptomeningeal collaterals at the base of the brain. The classical presentation of MMD is transient ischemic attacks (TIAs), ischemic strokes, and intracranial hemorrhages. Its natural history is often progressive and includes recurrent ischemic episodes with neurological and cognitive deterioration. Unfortunately, the disease is unresponsive to any medical treatment. Surgery aimed at revascularization of the hemispheres either by direct or indirect bypass techniques is the treatment of choice. Over the past years, there has been major progress in understanding MMD, including its molecular biology, genetics, pathophysiology, radiology and blood flow, and surgical management. This article reviews the major neurosurgical advances in the treatment of MMD. Genetics and PathophysiologyThe pathophysiology of MMD is poorly un...

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Arterial spin-labeling MR imaging in moyamoya disease compared with SPECT imaging

Cited by 81 publications

References 24 publications

Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Arterial spin labelling MRI for assessment of cerebral perfusion in children with moyamoya disease: comparison with dynamic susceptibility contrast MRI

Neurosurgical Advances in the Treatment of Moyamoya Disease

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