PT  - JOURNAL ARTICLE
AU  - Blauwblomme, T.
AU  - Lemaitre, H.
AU  - Naggara, O.
AU  - Calmon, R.
AU  - Kossorotof, M.
AU  - Bourgeois, M.
AU  - Mathon, B.
AU  - Puget, S.
AU  - Zerah, M.
AU  - Brunelle, F.
AU  - Sainte-Rose, C.
AU  - Boddaert, N.
TI  - Cerebral Blood Flow Improvement after Indirect Revascularization for Pediatric Moyamoya Disease: A Statistical Analysis of Arterial Spin-Labeling MRI
AID  - 10.3174/ajnr.A4592
DP  - 2015 Nov 19
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2015/11/19/ajnr.A4592.short
4100  - http://www.ajnr.org/content/early/2015/11/19/ajnr.A4592.full
AB  - 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-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.AbbreviationsASLarterial spin-labelingMMpediatric Moyamoya diseaseSPMstatistical parametric mapping