AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on May 22, 2008
doi: 10.3174/ajnr.A1129
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Quantitative Cerebrovascular Reserve Measured by Acetazolamide-Challenged Dynamic CT Perfusion in Ischemic Adult Moyamoya Disease: Initial Experience with Angiographic Correlation

K.H. Kanga, H.S. Kima and S.Y. Kima

a From the Department of Diagnostic Radiology, Ajou University, School of Medicine, Gyeonggi-do, South Korea


Figure 1
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  		Fig 1. ROIs drawn in a reference CT image (A) and vessel-removed MTT map (B). The ROIs were placed on cortical regions in the MCA territory, EBZ, ACA territory, and putamen in the section of BG level around the foramen of Monro.


Figure 2
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  		Fig 2. A 48-year-old woman with transient ischemic attack (case 16). A, Anteroposterior view of right internal carotid arteriogram shows severe stenosis in the proximal M1 portion of MCA with developed BMVs (modified Suzuki stage II). B, Anteroposterior view of left internal carotid arteriogram shows occlusion of distal ICA without antegrade flow (modified Suzuki stage IV). CBF maps before (C) and after (D) ACZ administration show decreased CVR in the left anterior EBZ (white arrow) and MCA territory (black arrow) ipsilateral to the hemisphere with higher modified Suzuki stage compared with contralateral hemisphere with lower modified Suzuki stage. Corresponding SPECT before (E) and after (F) ACZ administration show decreased CVR in the same areas.


Figure 3
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  		Fig 3. Scatterplot between baseline MTT and PCs of CBF and angiographic stages in the anterior EBZ. A, Angiographic stage versus MTT in the EBZ. B, Angiographic stage versus PC of CBF in the EBZ.


Figure 4
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  		Fig 4. Clustered box-and-whisker graphs show the differences in the mean values of hemodynamic parameters according to the presence of BMVs in each vascular territory. A, BMV versus normalized CBV. B, BMV versus normalized CBF. C, BMV versus normalized MTT. D, BMV versus PC of CBF.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X