Clinical assessment of cerebral hemodynamics in Moyamoya disease via multiple inversion time arterial spin labeling and dynamic susceptibility contrast-magnetic resonance imaging: A comparative study.
OBJECTIVE
For Moyamoya disease (MMD) patients, accurate hemodynamic assessment is critical for treatment selection and efficacy assessment. This study aims to investigate the clinical value of mTI-ASL in assessing the cerebral hemodynamics of MMD patients before and after revascularization, relative to DSC-MRI.


METHODS
Forty-one MMD patients underwent mTI-ASL and DSC-MRI during blood perfusion. Quantitative parameters for the bilateral supply vessels of middle and anterior cerebral arteries, including DSC-TTP, DSC-CBF, ASL-BAT, and ASL-CBF were measured. The correlations between DSC-ΔTTP (TTPhemisphere- TTPbrainstem) and ASL-ΔBAT (BAThemisphere- BATbrainstem) and between DSC-CBF and ASL-CBF were determined. The consistency between the two techniques in assessing the cerebral ischemic state before and after revascularization was analyzed.


RESULTS
DSC-ΔTTP and ASL-ΔBAT (r=0.36, P<0.001) and DSC-CBF and ASL-CBF (r=0.32, P<0.001) exhibited significant correlation on 824 regions of interest (ROIs) and similar numbers of ischemic areas on 902 ROIs (κ=0.82, P<0.001). The ischemic scores were 3.17±3.02 and 2.98±2.81 by DSC-MRI and ASL-MRI, respectively (ICC=0.92). For 15 surgically treated patients, the scores for blood perfusion improvement on the operated side were 3.13±1.68 and 3.27±1.33 with DSC-TTP and ASL-BAT, respectively (ICC=0.94).


CONCLUSIONS
Compared to DSC-MRI, mTI-ASL can assess the cerebral hemodynamics in MMD and evaluate ischemic state before revascularization and ischemia reduction after revascularization effectively. And mTI-ASL is more advantageous because it does not require contrast agents.
Department of Radiology, Affiliated Hospital of Academy of Military Medical Sciences, #8 Fengtai Dong Street, Fengtai District, 100071 Beijing, China.
Peng-Gang
PG
Qiao
Department of Neurosurgery, Affiliated Hospital of Academy of Military Medical Sciences, #8 Fengtai Dong Street, Fengtai District, 100071 Beijing, China.
Cong
C
Han
The Radiology Department, Affiliated Southwest Hospital, Third Military Medical University, Chongqing, China.
Zhi-Wei
ZW
Zuo
Department of Radiology, Affiliated Hospital of Academy of Military Medical Sciences, #8 Fengtai Dong Street, Fengtai District, 100071 Beijing, China.
Yi-Tuo
YT
Wang
Siemens Healthcare, MR Neuro-Applications, Erlangen, Germany.
Josef
J
Pfeuffer
Department of Neurosurgery, Affiliated Hospital of Academy of Military Medical Sciences, #8 Fengtai Dong Street, Fengtai District, 100071 Beijing, China. Electronic address: duanlian307@sina.com.
Lian
L
Duan
Germany Siemens Healthcare, MR Collaborations NE Asia, Beijing, China.
Tianyi
T
Qian
Department of Radiology, Affiliated Hospital of Academy of Military Medical Sciences, #8 Fengtai Dong Street, Fengtai District, 100071 Beijing, China. Electronic address: ligj307@sina.com.
Gong-Jie
GJ
Li
D000293:Adolescent; D000328:Adult; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D003287:Contrast Media; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D013113:Spin Labels
D003287:Contrast Media; D013113:Spin Labels
Arterial spin labeling; Cerebral hemodynamics; Ischemic state; Magnetic resonance imaging; Moyamoya disease