Arterial transit artifacts observed by arterial spin labeling in Moyamoya disease

Ukai, Ryo; Mikami, Takeshi; Nagahama, Hiroshi; Wanibuchi, Masahiko; Akiyama, Yukinori; Miyata, Kei; Mikuni, Nobuhiro

doi:10.1016/j.jstrokecerebrovasdis.2020.105058

Cited by 17 publications

(9 citation statements)

References 29 publications

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“…ATA on ASL images with a PLD of 1,500 ms has been reported to be correlated with the MRA score in MMA patients. In addition, PLDs of 1,500 ms had a wider range median of the ATA values and a higher correlation coefficient compared with PLDs of 1,000 and 2,000 ms ( Ukai et al, 2020 ). In this study, a PLD of 1,500 ms was adopted in the ASL exam.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Collateral Perfusion Using Arterial Spin Labeling: A Predictor of Surgical Collaterals in Moyamoya Angiopathy

Wang

Zhang

et al. 2022

Front. Neurosci.

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ObjectivesVarious degrees of surgical collateral circulation are often found in moyamoya angiopathy (MMA) patients after revascularization. Little is known about arterial spin labeling (ASL) that affects surgical collateral circulation. This study aimed to investigate the effect of ASL on surgical collaterals in patients with MMA after combined bypass surgery.MethodsMMA patients with complete radiological and clinical information, who had undergone combined bypass, were enrolled in this study. Surgical collaterals were classified as good or poor based on the Matsushima standard. Cerebral perfusion on ASL was quantitatively analyzed as relative cerebral blood flow (rCBF). The qualitative collateral score was calculated using a four-grade scale. Univariable and multivariable logistic regressions were performed to identify the predictors for surgical collaterals after combined bypass.ResultsIn total, 66 hemispheres of 61 patients (47 years old ± 8.66) were prospectively included (29 and 37 hemispheres with good and poor surgical collaterals, respectively). The presurgical collateral score was significantly lower in patients with good surgical collaterals (13.72 scores ± 7.83) than in those with poor surgical collaterals (19.16 scores ± 6.65, P = 0.005). The presurgical rCBF and modified Rankin scale (mRS) scores were not significantly different between the two groups (PrCBF = 0.639, PmRS = 0.590). The collateral score was significantly elevated (good: 13.72 scores ± 7.83 vs. 20.79 scores ± 6.65, P < 0.001; poor: 19.16 scores ± 6.65 vs. 22.84 scores ± 5.06, P < 0.001), and the mRS was reduced (good: 1.66 scores ± 1.14 vs. 0.52 scores ± 0.83, P < 0.001; poor: 1.49 scores ± 0.90 vs. 0.62 scores ± 0.76, P < 0.001) in patients after revascularization. Multivariable logistic regression showed that preoperative collateral scores [odds ratio (OR): 0.791; 95% confidence interval (CI): 0.695, 0.900; P < 0.001], age (OR: 0.181; 95% CI: 0.039, 0.854; P = 0.031), sex (OR: 0.154; 95% CI: 0.035, 0.676; P = 0.013), and hypertension (OR: 0.167; 95% CI: 0.038, 0.736; P = 0.018) were predictors of surgical collaterals after combined revascularization.ConclusionThe preoperative collateral score based on ASL could be a predictor for surgical collaterals in patients with MMA after combined bypass surgery. Combined with age, sex, and hypertension, it may have a better predictive effect.

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Section: Discussionmentioning

confidence: 99%

Preoperative Collateral Perfusion Using Arterial Spin Labeling: A Predictor of Surgical Collaterals in Moyamoya Angiopathy

Wang

Zhang

et al. 2022

Front. Neurosci.

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“…The decreased and slow blood flow might induce an ATA; therefore, cortical flow in moyamoya patients may resemble this hemodynamic status. The strength of the ATA alters according to the PLD value because the delayed blood flow due to stenosis or occlusion still remains in the cortical surface (24,27). Regarding this patient, ASL acquisitions with both shorter and longer PLD dramatically demonstrated conspicuous ATA in the bilateral hemispheric cortex, and this status has lasted almost 10 years to date.…”

Section: Discussionmentioning

confidence: 79%

“…Unexpectedly, there were serpiginous bright signals in the bilateral cerebral cortex and sulcus on ASL images. The bright intravascular signal known as arterial transit artifact (ATA) on ASL may indicate the presence and degree of collateral perfusion in moyamoya patients (23,24). The ATAs produce hyperintense signals along the cerebral cortical sulcus, which is caused by delayed blood flow due to the stenosis or occlusion of main arteries, or collateral flow accompanying the stenosis or occlusion (25,26).…”

Section: Discussionmentioning

confidence: 99%

“…Investigating the cause of the ATA is necessary to evaluate the pathophysiology of patients. As the arterial transit time of collateral blood flow is longer than that of normal anterograde blood flow in moyamoya patients, the intensity of ATA conveys information about the delayed arrival of blood flow and reflects the collateral flow (23,24). Studies have shown that ATAs can evaluate collateral circulation with high specificity (24).…”

Section: Discussionmentioning

confidence: 99%

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Recurrent transient ischemic attacks in a moyamoya syndrome patient with ultra-long imaging follow-up

Zhang¹,

Xing²,

Zhang³

2022

Quant Imaging Med Surg

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“…To calculate rCBF after an acetazolamide challenge, two look-up tables were used to reflect the effect of radioactivity in the brain from the first dose of IMP. The data were transferred to the workstation, and the rCBF of the hemisphere was measured by creating a region of interest using 'NEURO FLEXER’ software (AZE Corporation, Kanagawa, Japan) 15 . The NEURO FLEXER volume-of-interest template contains 20 regions based on arterial territories, including the anterior cerebral arterial (ACA), middle cerebral arterial (MCA), and posterior cerebral arterial (PCA) territories.…”

Section: Methodsmentioning

confidence: 99%

Brain volume measured by synthetic magnetic resonance imaging in adult moyamoya disease correlates with cerebral blood flow and brain function

Kikuchi,

Togao,

Yamashita

et al. 2024

Sci Rep

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Moyamoya disease (MMD) is characterized by progressive arterial occlusion, causing chronic hemodynamic impairment, which can reduce brain volume. A novel quantitative technique, synthetic magnetic resonance imaging (SyMRI), can evaluate brain volume. This study aimed to investigate whether brain volume measured with SyMRI correlated with cerebral blood flow (CBF) and brain function in adult MMD. In this retrospective study, 18 adult patients with MMD were included. CBF was measured using iodine-123-N-isopropyl-p-iodoamphetamine single photon emission computed tomography. Cerebrovascular reactivity (CVR) to acetazolamide challenge was also evaluated. Brain function was measured using the Wechsler Adult Intelligence Scales (WAIS)-III/IV and the WAIS-R tests. Gray matter (GM), white matter, and myelin-correlated volumes were evaluated in six areas. Resting CBF was positively correlated with GM fractions in the right anterior cerebral arterial and right middle cerebral arterial (MCA) territories. CVR was positively correlated with GM fraction in the right posterior cerebral arterial (PCA) territory. Full-Scale Intelligence Quotient and Verbal Comprehension Index scores were marginally positively correlated with GM fractions in the left PCA territory. Processing Speed Index score was marginally positively correlated with GM fraction in the right MCA territory. The SyMRI-measured territorial GM fraction correlated with CBF and brain function in patients with MMD.

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Arterial transit artifacts observed by arterial spin labeling in Moyamoya disease

Cited by 17 publications

References 29 publications

Preoperative Collateral Perfusion Using Arterial Spin Labeling: A Predictor of Surgical Collaterals in Moyamoya Angiopathy

Preoperative Collateral Perfusion Using Arterial Spin Labeling: A Predictor of Surgical Collaterals in Moyamoya Angiopathy

Recurrent transient ischemic attacks in a moyamoya syndrome patient with ultra-long imaging follow-up

Brain volume measured by synthetic magnetic resonance imaging in adult moyamoya disease correlates with cerebral blood flow and brain function

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