RT Journal Article
SR Electronic
T1 Standardized MR Perfusion Scoring System for Evaluation of Sequential Perfusion Changes and Surgical Outcome of Moyamoya Disease
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 260
OP 266
DO 10.3174/ajnr.A5945
VO 40
IS 2
A1 Y.-H. Lin
A1 M.-F. Kuo
A1 C.-J. Lu
A1 C.-W. Lee
A1 S.-H. Yang
A1 Y.-C. Huang
A1 H.-M. Liu
A1 Y.-F. Chen
YR 2019
UL http://www.ajnr.org/content/40/2/260.abstract
AB BACKGROUND AND PURPOSE: Simple-but-precise evaluation of cerebral perfusion is crucial for the treatment of Moyamoya disease. We aimed to develop a standardized scoring system for MR perfusion suitable for Moyamoya disease evaluation and investigate the postoperative serial changes and outcome predictors.MATERIALS AND METHODS: From January 2013 to December 2016, patients diagnosed with Moyamoya disease and receiving indirect revascularization were recruited prospectively. Clinical data and serial imaging studies were analyzed. The TTP maps were standardized using cerebellar reference values. We developed a scoring system of standardized TTP maps: 14 points for each hemisphere with higher points indicating better perfusion.RESULTS: In total, 24 children (4–17 years of age, 41 hemispheres) and 20 adults (18–51 years of age, 34 hemispheres) were included. The mean preoperative TTP scores were higher in children (7.34 ± 3.90) than in adults (4.88 ± 3.24). The standardized TTP maps revealed dynamic improvement with an increase in the corresponding scores at the 1-, 3-, and 6-month postoperative follow-ups; the scores stabilized after 6 months. The mean improvement in the 6-month scores of the pediatric and adult groups was 4.15 ± 3.55 and 6.03 ± 3.04, respectively. The 6-month TTP score improvements were associated with Matsushima grades. If we took score improvement as the outcome, the preoperative TTP score was the only significant predictor in multivariable analysis.CONCLUSIONS: The standardized TTP maps and scoring system facilitated the quantification of the sequential perfusion changes during Moyamoya disease treatment. The preoperative perfusion status was the only predictor of indirect revascularization outcome.EDASencephaloduroarteriosynangiosisEPSencephalopericraniosynangiosisMMDMoyamoya diseaseMRPMR perfusion