Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya.

Autor: Lehman LL; Department of Neurology, Boston Children's Hospital, Boston, Massachusetts. Electronic address: laura.lehman@childrens.harvard.edu., Wu C; Department of Neurology, Boston Children's Hospital, Boston, Massachusetts., Kaseka ML; Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec., Muthusami P; Department of Diagnostic Imaging, Hospital for Sick Kids, Toronto, Ontario., Armstrong D; Department of Diagnostic Imaging, Hospital for Sick Kids, Toronto, Ontario., Dirks P; Department of Neurosurgery, Hospital for Sick Kids, Toronto, Ontario., Shroff M; Department of Diagnostic Imaging, Hospital for Sick Kids, Toronto, Ontario., Moharir M; Division of Neurology, Hospital for Sick Children, Toronto, Ontario., Macgregor D; Division of Neurology, Hospital for Sick Children, Toronto, Ontario., deVeber G; Division of Neurology, Hospital for Sick Children, Toronto, Ontario., Dlamini N; Division of Neurology, Hospital for Sick Children, Toronto, Ontario.
Jazyk: angličtina
Zdroj: Pediatric neurology [Pediatr Neurol] 2024 Oct; Vol. 159, pp. 1-3. Date of Electronic Publication: 2024 Jun 25.
DOI: 10.1016/j.pediatrneurol.2024.06.008
Abstrakt: Background: The gold standard for evaluation of the severity of moyamoya vasculopathy is the Suzuki grade determined with cerebral catheter angiography (CA). With greater use of magnetic resonance angiography (MRA) it is important to understand if MRA is truly comparable to CA.
Methods: Children with moyamoya were evaluated using the Suzuki score for CA and the modified MRA six-stage Suzuki score to describe the angiographic findings in moyamoya from initial narrowing of the distal internal carotid artery to the "puff of smoke" appearance of the lenticulostriate collaterals and finally to the disappearance of this network of collaterals. Using Cohen kappa we compared Suzuki grade based on CA with MRA in the same patients.
Results: A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (P < 0.0001), which is a moderate correlation.
Conclusions: We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.
Competing Interests: Declaration of competing interest Nothing to report.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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