Localized 1H-MR spectroscopy in moyamoya disease before and after revascularization surgery.
OBJECTIVE
To evaluate, using localized proton magnetic resonance spectroscopy ((1)H-MRS), the cerebral metabolic change apparent after revascularization surgery in patients with moyamoya disease.


METHODS
Sixteen children with moyamoya disease and eight age-matched normal controls underwent MR imaging, MR angiography, conventional angiography, and (99m)Tc- ECD SPECT. Frontal white matter and the basal ganglia of both hemispheres were subjected to localized (1)H-MRS, and after revascularization surgery, four patients underwent follow-up (1)H-MRS.


RESULTS
Decreased NAA/Cr ratios (1.35+/-0.14 in patients vs. 1.55+/-0.24 in controls) and Cho/Cr ratios (0.96+/-0.13 in patients vs. 1.10+/-0.11 in controls) were observed in frontal white matter. After revascularization surgery, NAA/Cr and Cho/Cr ratios in this region increased. In the basal ganglia, there is no abnormal metabolic ratios.


CONCLUSIONS
Localized (1)H-MRS revealed abnormal metabolic change in both hemispheres of children with moyamoya disease. Because of its non-invasive nature, (1)H-MRS is potentially useful for the preoperative evaluation of metabolic abnormalities and their postoperative monitoring.
Lim
Soo Mee
SM
Department of Diagnostic Radiology, College of Medicine, Ewha Womans University Hospital, Yangcheon-gu, Seoul, Korea. soomee@mm.ewha.ac.kr
Choi
Hye-Young
HY
Suh
Jung Soo
JS
Lee
Jung Hee
JH
Lim
Keun Ho
KH
Suh
Dae Chul
DC
Lee
Ho Kyu
HK
Lim
Tae-Hwan
TH
Ra
Young Shin
YS
D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D016022:Case-Control Studies; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D002648:Child; D002794:Choline / Q000378:metabolism; D003545:Cysteine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009072:Moyamoya Disease / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery*; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D001224:Aspartic Acid; C000179:N-acetylaspartate; C059659:technetium Tc 99m bicisate; D003545:Cysteine; D002794:Choline