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Moyamoya disease: evaluation of postoperative revascularization using multiphase selective arterial spin labeling MRI
Tsukasa Saida1, Tomohiko Masumoto, Yasunobu Nakai
1Department of Radiodiagnosis, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan. saida_sasaki_tsukasa@yahoo.co.jp
Purpose:
The purpose of this study was to evaluate cerebral blood flow through the bypass in operated patients with Moyamoya disease using multiphase selective arterial spin labeling (ASL) technique.
Materials And Methods:
Fifteen surgically treated cerebral hemispheres from 11 patients with Moyamoya disease were included. Selective ASL examinations were performed during the early postoperative period (mean, 5.5 days) on 4 hemispheres and late postoperative period (mean, 332.7 days) on 15 hemispheres. The labeling slab was positioned at the bypassed external carotid artery and 5 slices in each of the 10 sequential phases were acquired using a 3-T scanner.
Results:
Two of 4 early postoperative ASL examinations and all late postoperative ASL examinations demonstrated blood flow through the bypass. The remaining 2 early postoperative ASL examinations showed absence of blood flow; however, blood flow improved on follow-up examinations.
Conclusion:
Multiphase selective ASL technique can provide information about the dynamics of postoperative blood flow through the bypass in Moyamoya disease.
Insights
Multiphase selective arterial spin labeling (ASL) effectively assesses bypass blood flow in Moyamoya disease patients post-surgery. This technique reveals dynamic changes in cerebral blood flow through the bypass over time.
Area of Science:
- Neurology
- Medical Imaging
- Vascular Surgery
Background:
- Moyamoya disease is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
- Surgical revascularization, such as bypass grafting, is a common treatment for Moyamoya disease to restore cerebral blood flow.
- Accurate assessment of postoperative bypass function is crucial for patient management.
Purpose of the Study:
- To evaluate cerebral blood flow through surgical bypasses in Moyamoya disease patients.
- To assess the utility of multiphase selective arterial spin labeling (ASL) for this evaluation.
Main Methods:
- The study included 15 hemispheres from 11 patients with Moyamoya disease who underwent surgery.
- Multiphase selective arterial spin labeling (ASL) was performed using a 3-T scanner.
- Examinations were conducted in the early (mean 5.5 days) and late (mean 332.7 days) postoperative periods.
Main Results:
- Blood flow through the bypass was detected in 2 early and all 15 late postoperative ASL examinations.
- Two early examinations showed absent flow, but subsequent follow-up demonstrated improved blood flow.
- The multiphase selective ASL technique successfully visualized bypass patency and flow dynamics.
Conclusions:
- Multiphase selective ASL is a valuable tool for assessing postoperative cerebral blood flow dynamics in Moyamoya disease.
- The technique can identify early bypass non-function and monitor improvement over time.
- This imaging method aids in the management of patients with Moyamoya disease undergoing surgical revascularization.
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