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Localized 1H-MR spectroscopy in moyamoya disease before and after revascularization surgery
Soo Mee Lim1, Hye-Young Choi, Jung Soo Suh
1Department of Diagnostic Radiology, College of Medicine, Ewha Womans University Hospital, Yangcheon-gu, Seoul, Korea. soomee@mm.ewha.ac.kr
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.
Materials And 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.
Conclusion:
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.