Noninvasive method for mapping CVR in moyamoya disease using ASL-MRI

Eur J Radiol. 2015 Jun;84(6):1137-43. doi: 10.1016/j.ejrad.2015.03.011. Epub 2015 Mar 18.

Abstract

Purpose: To project a noninvasive method for mapping cerebrovascular reserve (CVR) in moyamoya disease (MMD) using ASL-MRI.

Methods: 16 MMD patients underwent cerebral blood flow (CBF) examinations by standard ASL-MRI, pulse-wave-synchronized ASL-MRI (pulsy ASL-MRI) which tagged the arterial blood coincident with a peak of a pulse wave, and single photon emission computed tomography (SPECT) imagings with iodine-123-N-isopropyl-p-iodoamphetamine in the resting (rest-IMP) and after acetazolamide challenge (ACZ-IMP). Hemispheric 32-sided cerebral blood flow (CBF) values were measured with normalized CBF maps created from standard ASL-MRI (standard-ASL value), pulsy ASL-MRI (pulsy-ASL value), rest-IMP (rest-IMP value), and ACZ-IMP (ACZ-IMP value). CVR based on rest-IMP and ACZ-IMP values (IMP-CVR) was calculated. ASL-CVR was also calculated on the basis of corrected standard-ASL values and pulsy-ASL values, which were adjusted to the ACZ-IMP values and rest-IMP values, respectively, by the least-squares method. We assessed the relationships between rest-IMP values and pulsy-ASL values, ACZ-IMP values and standard-ASL values, and IMP-CVR and ASL-CVR.

Results: Significant relationships were observed between rest-IMP values and pulsy-ASL values (correlation coefficient (r=0.557, p<0.01)), ACZ-IMP values and standard-ASL values (r=0.825, p<0.01), and IMP-CVR and ASL-CVR (r=0.736, p<0.01).

Conclusions: ASL-MRI is equivalent to SPECT and that it might serve as a noninvasive method for mapping CVR in MMD.

Keywords: Arterial spin labeling; Brain Perfusion; MRI; Moyamoya disease; Pulse wave synchronization; SPECT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetazolamide
  • Adolescent
  • Adult
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Brain / pathology
  • Cerebrovascular Circulation / physiology*
  • Child
  • Female
  • Humans
  • Iodine Radioisotopes
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Moyamoya Disease / physiopathology*
  • Multimodal Imaging / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Young Adult

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Acetazolamide

Supplementary concepts

  • Moyamoya disease 1