Clinical Use of Cerebrovascular Compliance Imaging to Evaluate Revascularization in Patients With Moyamoya
| Autor: | Blaise deB. Frederick, Meher R. Juttukonda, Jennifer M. Watchmaker, Manus J. Donahue, Larry T Davis, Matthew R. Fusco, Sarah K Lants, Howard S. Kirshner |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Neuroimaging Research—Laboratory Revascularization Young Adult 03 medical and health sciences 0302 clinical medicine Text mining medicine Medical imaging Humans Moyamoya disease Young adult Cerebral Revascularization medicine.diagnostic_test business.industry Angiography Digital Subtraction Magnetic resonance imaging Digital subtraction angiography Middle Aged medicine.disease Magnetic Resonance Imaging body regions Cerebrovascular Circulation 030220 oncology & carcinogenesis Angiography Female Surgery Neurology (clinical) Radiology Moyamoya Disease business 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgery. 84:261-271 |
| ISSN: | 1524-4040 0148-396X |
| Popis: | BACKGROUND: Surgical revascularization is often performed in patients with moyamoya, however routine tools for efficacy evaluation are underdeveloped. The gold standard is digital subtraction angiography (DSA); however, DSA requires ionizing radiation and procedural risk, and therefore is suboptimal for routine surveillance of parenchymal health. OBJECTIVE: To determine whether parenchymal vascular compliance measures, obtained noninvasively using magnetic resonance imaging (MRI), provide surrogates to revascularization success by comparing measures with DSA before and after surgical revascularization. METHODS: Twenty surgical hemispheres with DSA and MRI performed before and after revascularization were evaluated. Cerebrovascular reactivity (CVR)-weighted images were acquired using hypercapnic 3-Tesla gradient echo blood oxygenation level-dependent MRI. Standard and novel analysis algorithms were applied (i) to quantify relative CVR (rCVR(RAW)), and decompose this response into (ii) relative maximum CVR (rCVR(MAX)) and (iii) a surrogate measure of the time for parenchyma to respond maximally to the stimulus, CVR(DELAY). Measures between time points in patients with good and poor surgical outcomes based on DSA-visualized neoangiogenesis were contrasted (signed-rank test; significance: 2-sided P |
| Databáze: | OpenAIRE |
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