The contribution of imaging in diagnosis, preoperative assessment, and follow-up of moyamoya disease

Bacigaluppi, Susanna; Dehdashti, Amir R.; Agid, Ronit; Krings, Timo; Tymianski, Michael; Mikulis, David

doi:10.3171/2009.01.focus08296

Cited by 42 publications

(31 citation statements)

References 87 publications

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“…The Xe-CT technique has been used to assess hemodynamic stress in Moyamoya disease and is frequently used to evaluate the postoperative CBF [22,23,27]. However, the Xe-CT technique also has some disadvantages, including a relatively long acquisition time, it is prone to motion artifacts, and some patients cannot tolerate inhalation of xenon through a face mask during the procedure and may experience respiratory failure, headaches, nausea, vomiting, or convulsions.…”

Section: Discussionmentioning

confidence: 99%

“…However, the Xe-CT technique also has some disadvantages, including a relatively long acquisition time, it is prone to motion artifacts, and some patients cannot tolerate inhalation of xenon through a face mask during the procedure and may experience respiratory failure, headaches, nausea, vomiting, or convulsions. As a result, the Xe-CT technique is not currently readily available in many countries [22,23]. …”

Section: Discussionmentioning

confidence: 99%

“…Second, the availability of a cyclotron is required to produce PET tracers because they are very short-lived radiopharmaceutical materials. Third, the number of available PET and SPECT scanners is far less than MR and CT [22,23]. SPECT is not strictly quantitative and has a poor spatial resolution [23].…”

Section: Discussionmentioning

confidence: 99%

“…The PET and SPECT techniques have been widely used to assess cerebral perfusion [21,22,23,24,25,26], but they have several disadvantages. First, PET and SPECT requires delivery of ionizing radiation and is relatively more costly.…”

Section: Discussionmentioning

confidence: 99%

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Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Zhou

Xiong

et al. 2013

Cerebrovasc Dis

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Background: The best strategy to assess the changes in brain hemodynamics following superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in patients with Moyamoya disease remains unknown. The purpose of the present study was to assess cerebral hemodynamics using perfusion-weighted magnetic resonance imaging (PWI) before and after STA-MCA bypass surgery in patients with Moyamoya disease. Methods: STA-MCA bypass surgeries were performed on 23 symptomatic cerebral hemispheres in 21 patients (11 females/10 males, age 11-62 years) with Moyamoya disease due to cerebral ischemic attacks or intracranial hemorrhages. Brain PWI images were obtained in the frontal lobes, the temporal lobes, the occipital lobes, and the basal ganglia before and after STA-MCA bypass surgery. The relative parameters cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) derived from PWI were calculated. All patients underwent CT angiography or MR angiography after surgery in order to confirm the patency of bypass. Results: According to preoperative PWI, there was significant hypoperfusion in the symptomatic temporal and frontal lobes. According to postoperative PWI, the regional CBF had increased in both the temporal and frontal lobes on the operative side (p < 0.05, versus preoperative data). In the postoperative CBV maps, there was a significant decrease in the occipital lobe on the operative side (p < 0.05, versus preoperative data). The postoperative MTT in the temporal lobe, frontal lobe and basal ganglia area on the operative side was short, relative to the preoperative MTT (p < 0.05). The CT angiography or MR angiography imaging demonstrated patency of the bypass in all patients after surgery. During the follow-up period, all patients showed significant improvement in neurological function postoperatively. Conclusions: This study demonstrates that STA-MCA bypass is a safe and effective surgical treatment for Moyamoya disease. PWI enables an effective and objective assessment of hemodynamics before and after STA-MCA bypass surgery in patients with Moyamoya disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Zhou

Xiong

et al. 2013

Cerebrovasc Dis

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“…Few reports have been reported regarding post-op perfusion and hemodynamic changes of patients affected by Moyamoya vasculopathy [6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

Bilateral flow changes after extracranial–intracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies

Esposito

Pepa

Sabatino

et al. 2015

British Journal of Neurosurgery

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We report on a symptomatic case in which the whole intracranial blood supply was provided by a single vertebral artery as both internal carotid arteries were occluded and the contralateral vertebral artery was severely hypoplasic. The patient was treated by a flow-augmentation extracranial-intracranial bypass. Preoperative perfusion studies were essential in tailoring surgical strategy. Keypoints of the paper are contralateral perfusion changes after unilateral bypass surgery. The patient experienced a total recovery from symptoms and a bilateral improvement in brain perfusion, probably as consequence of post-operative hemodynamic rearrangement. Originally published at: Esposito, Giuseppe; Della Pepa, Giuseppe Maria; Sabatino, Giovanni; Gaudino, Simona; Puca, Alfredo; Maira, Giulio; Marchese, Enrico; Albanese, Alessio (2015). Bilateral flow changes after extracranialintracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies. British Journal of Neurosurgery, 29 (5) Disclosure statement: the authors declare no interest to disclose, they have any personal or institutional financial interest in drugs, materials, or devices described in this submission and that they did not receive any specific funding. The paper and any of its contents have been presented previously. AbstractWe report on a symptomatic case in which the whole intracranial blood supply was provided by a single vertebral artery as both carotid were occluded and the contralateral vertebral artery was severely hypoplasic. The patient was treated by a flow-augmentation extra-intracranial bypass.Preoperative perfusion studies were essential in tailoring surgical strategy. Keypoint of the paper are contralateral perfusion changes after unilateral bypass surgery. The patient experienced a total recover from symptoms and a bilateral improvement in brain perfusion, probably as consequence of post-operative haemodynamic rearrangement.

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Transcranial color Doppler sonography as an alternative tool for evaluation of terminal internal carotid artery steno‐occlusion in moyamoya disease

Wang

Zhang

Wei

et al. 2021

J of Clinical Ultrasound

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Objective: To investigate color Doppler ultrasonography criteria and its value in assessing the steno-occlusion of the terminal internal carotid artery in moyamoya disease.Methods: According to the digital subtraction angiography findings, patients were divided into three groups: occlusion of the terminal internal carotid artery, >50% stenosis, and ≤50% stenosis. We measured the terminal and proximal internal carotid artery parameters of each group using transcranial and cervical color Doppler sonography.Results: Blood flow signals in 12 terminal internal carotid arteries were absent, which were verified as occlusion by digital subtraction angiography. Parameters were obtained in the remaining 159 terminal/proximal internal carotid arteries to predict cutoffs for >50% stenosis and occlusion. For >50% stenosis, mean flow velocity >88.50 cm/s in the terminal internal carotid artery could achieved the highest receiver operating characteristic curve area of 0.776 with 62.50% sensitivity, 88.15% specificity, 48.39% positive predictive values, 92.97% negative predictive value, and 84.27% overall accuracy. For the occlusion, mean flow velocity <49.50 cm/s in the terminal internal carotid artery achieve the highest receiver operating characteristic curve area of 0.734 with 55.56% sensitivity, 83.81% specificity, 63.83% positive predictive values, 78.57% negative predictive value, and 74.21% overall accuracy. The area under receiver operating characteristic curve cutoffs for other parameters were less than 0.7. Conclusion:Mean flow velocity of terminal internal carotid artery provides useful diagnostic information for detecting steno-occlusion in moyamoya disease. It may be used as an alternative tool to evaluate steno-occlusion of the terminal internal carotid artery in moyamoya disease.

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The contribution of imaging in diagnosis, preoperative assessment, and follow-up of moyamoya disease

Abstract: The aim of this review was to evaluate the imaging tools used in diagnosis and perioperative assessment of moyamoya disease, with particular attention to the last decade.

Cited by 42 publications

References 87 publications

Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Bilateral flow changes after extracranial–intracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies

Transcranial color Doppler sonography as an alternative tool for evaluation of terminal internal carotid artery steno‐occlusion in moyamoya disease

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