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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



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



Journal of Neuroradiology. Journal de Neuroradiologie 44(4): 273-280



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. 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. 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). 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.

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Accession: 059506130

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PMID: 28168990

DOI: 10.1016/j.neurad.2016.12.006


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