Noninvasive method for mapping CVR in moyamoya disease using ASL-MRI
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ASL-MRI was compared to iodoamphetamine (IMP)-SPECT at rest and following Diamox in 16 patients with moyamoya disease (MMD). ASL-MRI was acquired using standard sequences and innovative pulse-wave-synchronized ASL (“pulsy-ASL”) which tags the arterial blood coincident with a peak of a pulse wave as guided by a pulse-wave-detector placed on a finger during MR acquisition. Results showed resting IMP-SPECT correlates best with pulsy-ASL, while Diamox-IMP correlates best with standard ASL;
Methods
The current retrospective research was approved by our institutional review board, and written informed consent was obtained from all patients.
Results
The measurements of perfusion values or CVR were as follows: rest-IMP value = 33.0 ± 7.1 (mL/100 g/min), ACZ-IMP value = 42.0 ± 10.1 (mL/100 g/min), IMP-CVR = 30.9 ± 40.4 (%), standard-ASL value = 26.2 ± 12.7 (mL/100 g/min), pulsy-ASL value = 23.6 ± 13.2 (mL/100 g/min), ASL-CVR = 26.8 ± 16.4 (%). Overall, the CBF values of standard-ASL and pulsy-ASL were lower than those of rest-IMP and ACZ-IMP, which might be due to the tendency to underestimate ASL in MMD, and which was consistent with those in the previous report [20].
Fig.
Discussion
In a previous comparison of the brain perfusion measurement by ASL-MRI compared with 123I-IMP SPECT in patients with MMD, the relationship in hemispheric CBF between standard ASL-MRI and ACZ-IMP was reported to have a high correlation coefficient [20]. In our study, ACZ-IMP was again significantly correlated with the standard ASL-MRI. Although the reason for this relationship was unclear, the prolonged ATT might be important.
Although MMD can have the impairment of the blood flow, the
Authors’ contribution
Noguchi T involved in Project development, data collection and manuscript writing. Kawashima M, Egashira Y and Azama S helped in data collection. Nishihara M analysed the data. Irie H involved in Project Management.
Conflict of interest
None declared.
Ethical approval
We declare that all human studies have been approved by the institutional review board of Saga University Hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The current retrospective research was approved by our institutional review board, and written informed consent was obtained from all patients.
Acknowledgement
The current article is partly supported by Grant-in-Aid for Scientific Research of Japan Society for the Promotion of Science (#24591774).
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