Arterial Spin-Labeling Magnetic Resonance Imaging After Revascularization of Moyamoya Disease

• Published in: Journal of stroke and cerebrovascular diseases Vol. 22; no. 6; pp. 811 - 816
• Main Authors: Sugino, Toshiya, MD, Mikami, Takeshi, MD, Miyata, Kei, MD, Suzuki, Kengo, MD, Houkin, Kiyohiro, MD, Mikuni, Nobuhiro, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2013
• Subjects: Adolescent; Adult; Blood Pressure; Brain Edema - diagnosis; Brain Edema - physiopathology; byperperfusion; Cardiovascular; Cerebral Arteries - diagnostic imaging; Cerebral Arteries - physiopathology; Cerebral Arteries - surgery; Cerebral perfusion; Cerebral Revascularization - adverse effects; Cerebrovascular Circulation; Child; Child, Preschool; Female; flow-sensitive alternation inversion recovery; Humans; Iofetamine; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Middle Aged; Moyamoya Disease - diagnosis; Moyamoya Disease - physiopathology; Moyamoya Disease - surgery; Myocardial Perfusion Imaging - methods; Neurology; Predictive Value of Tests; Radiography; Radiopharmaceuticals; single photon emission computed tomography; Spin Labels; Time Factors; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Young Adult; flow-sensitive alternation inversion recovery; byperperfusion; Cerebral perfusion; single photon emission computed tomography
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2012.05.010

Arterial spin labeling (ASL) magnetic resonance imaging (MRI) is a technique for depicting cerebral perfusion without contrast medium. The purpose of this study was to determine whether ASL can be used to detect hyperperfusion after revascularization for moyamoya disease as effectively as N-isopropyl-[123I]β-iodoamphetamine (123 I-IMP) single-photon emission computed tomography (SPECT). Fifteen consecutive patients with moyamoya disease were included in the study. All patients underwent surgical revascularization. Postoperatively, regional cerebral blood flow (rCBF) was measured by flow-sensitive alternating inversion recovery (FAIR) ASL and123 I-IMP SPECT during the acute stage, and rCBF of the operative side was compared with the other side. The asymmetry ratio (AR) was then calculated from the rCBF as measured using each modality. The postoperative AR of ASL was moderately correlated with that of123 I-IMP SPECT ( y = 0.180 x + 0.819; R = 0.80; P = .0003). In this series, 2 patients (13.3%) suffered symptomatic hyperperfusion after revascularization and accordingly exhibited increased AR of ASL. Our data indicate that early increases in rCBF in patients with hyperperfusion could be detected using FAIR ASL supplemental to123 I-IMP SPECT after revascularization. Our data indicate that FAIR ASL is a convenient method for evaluating hyperperfusion that can be performed repeatedly without the use of contrast medium or radioisotopes.