@article {Blauwblomme706, author = {T. Blauwblomme and H. Lemaitre and O. Naggara and R. Calmon and M. Kossorotoff and M. Bourgeois and B. Mathon and S. Puget and M. Zerah and F. Brunelle and C. Sainte-Rose and N. Boddaert}, title = {Cerebral Blood Flow Improvement after Indirect Revascularization for Pediatric Moyamoya Disease: A Statistical Analysis of Arterial Spin-Labeling MRI}, volume = {37}, number = {4}, pages = {706--712}, year = {2016}, doi = {10.3174/ajnr.A4592}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: The severity of Moyamoya disease is generally scaled with conventional angiography and nuclear medicine. Arterial spin-labeling MR imaging is now acknowledged for the noninvasive quantification of cerebral blood flow. This study aimed to analyze CBF modifications with statistical parametric mapping of arterial spin-labeling MR imaging in children undergoing an operation for Moyamoya disease.MATERIALS AND METHODS: We included 15 children treated by indirect cerebral revascularization with multiple burr-holes between 2011 and 2013. Arterial spin-labeling MR imaging and T1 sequences were then analyzed under SPM8, according to the general linear model, before and after the operation (3 and 12 months). Voxel-based analysis was performed at the group level, comparing all diseased hemispheres with all normal hemispheres and, at the individual level, comparing each patient with a control group.RESULTS: Group analysis showed statistically significant preoperative hypoperfusion in the MCA territory in the Moyamoya hemispheres and a significant increase of cerebral perfusion in the same territory after revascularization (P \< .05 family-wise error{\textendash}corrected). Before the operation, individual analysis showed significant hypoperfusion for each patient co-localized with the angiographic defect on DSA. All except 1 patient had improvement of CBF after revascularization, correlated with their clinical status.CONCLUSIONS: SPM analysis of arterial spin-labeling MR imaging offers a noninvasive evaluation of preoperative cerebral hemodynamic impairment and an objective assessment of postoperative improvement in children with Moyamoya disease.ASLarterial spin-labelingMMpediatric Moyamoya diseaseSPMstatistical parametric mapping}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/37/4/706}, eprint = {https://www.ajnr.org/content/37/4/706.full.pdf}, journal = {American Journal of Neuroradiology} }