Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Ppublish 10 citations
PubMed: 36408536 DOI: 10.1177/0271678X221140343
Revascularization improves vascular hemodynamics - a study assessing cerebrovascular reserve and transit time in Moyamoya patients using MRI.
J Cereb Blood Flow Metab 43(2_suppl):138-151
Authors: Moss Y Zhao, Rui Duarte Armindo, Andrew J Gauden, Benjamin Yim, Elizabeth Tong, Michael Moseley, Gary K Steinberg, Greg Zaharchuk
Affiliations
- Department of Radiology, Stanford University, Stanford, CA, USA.
- Department of Neuroradiology, Hospital Beatriz Ângelo, Loures, Lisbon, Portugal.
- Department of Neurosurgery, Stanford University, Stanford, CA, USA.
Abstract
Cerebrovascular reserve (CVR) reflects the capacity of cerebral blood flow (CBF) to change. Decreased CVR implies poor hemodynamics and is linked to a higher risk for stroke. Revascularization has been shown to improve CBF in patients with vasculopathy such as Moyamoya disease. Dynamic susceptibility contrast (DSC) can measure transit time to evaluate patients suspected of stroke. Arterial spin labeling (ASL) is a non-invasive technique for CBF, CVR, and arterial transit time (ATT) measurements. Here, we investigate the change in hemodynamics 4-12 months after extracranial-to-intracranial direct bypass in 52 Moyamoya patients using ASL with single and multiple post-labeling delays (PLD). Images were collected using ASL and DSC with acetazolamide. CVR, CBF, ATT, and time-to-maximum (Tmax) were measured in different flow territories. Results showed that hemodynamics improved significantly in regions affected by arterial occlusions after revascularization. CVR increased by 16 ± 11% (p < 0.01) and 25 ± 13% (p < 0.01) for single- and multi-PLD ASL, respectively. Transit time measured by multi-PLD ASL and post-vasodilation DSC reduced by 13 ± 7% (p < 0.01) and 9 ± 5% (p < 0.01), respectively. For all regions, ATT correlated significantly with Tmax (R = 0.59, p < 0.01). Thus, revascularization improved CVR and decreased transit times. Multi-PLD ASL can serve as an effective and non-invasive modality to examine vascular hemodynamics in Moyamoya patients.
MeSH
Stroke, Hemodynamics, Cerebrovascular Circulation
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