Prediction of the Clinical Outcome of Pediatric Moyamoya Disease With Postoperative Basal/Acetazolamide Stress Brain Perfusion SPECT After Revascularization Surgery

So, Young; Lee, Ho‐Young; Kim, Seung-Ki; Lee, Jae Sung; Wang, Kyu-Chang; Cho, Byung Kyu; Kang, Eunjoo; Lee, Dong Hoon

doi:10.1161/01.str.0000170709.95185.b1

Cited by 107 publications

(75 citation statements)

References 21 publications

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“…Using acetazolamide and single positron emission CT, So et al compared pre-and postrevascularization CVR studies in clinically symptomatic children with moyamoya disease. 9 They found that patients with abnormal preoperative CVR demonstrated improvement in both clinical status and CVR after revascularization, likely due to the augmented cerebral blood flow. Interestingly, the authors also found that patients with persistent reductions in CVR postoperatively were found to be at a higher risk for developing ischemic attacks and recommended reoperating 9 if that were the case.…”

Section: Discussionmentioning

confidence: 98%

Measurement of Cerebrovascular Reactivity in Pediatric Patients With Cerebral Vasculopathy Using Blood Oxygen Level-Dependent MRI

Han

Mikulis

Mardimae

et al. 2011

Stroke

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Background and Purpose— Cerebrovascular reactivity (CVR) is an indicator of cerebral hemodynamics. In adults with cerebrovascular disease, impaired CVR has been shown to be associated with an increased risk of stroke. In children, however, CVR studies are not common. This may be due to the difficulties and risks associated with current CVR study methodologies. We have previously described the application of precise control of end-tidal carbon dioxide partial pressure for CVR studies in adults. Our aim is to report initial observations of CVR studies that were performed as part of a larger observational study regarding investigations in pediatric patients with cerebral vascular disease. Methods— Thirteen patients between the ages of 10 and 16 years (10 with a diagnosis of Moyamoya vasculopathy and 3 with confirmed, or suspected, intracranial vascular stenosis) underwent angiography, MRI, and functional blood oxygen level-dependent MRI mapping of CVR to hypercapnia. The results of the CVR study were then related to both the structural imaging and clinical status. Results— Sixteen blood oxygen level-dependent MRI CVR studies were performed successfully in 13 consecutive patients. Twelve of the 13 patients with angiographic abnormalities also had CVR deficits in the corresponding downstream vascular territories. CVR deficits were also seen in 8 of 9 symptomatic patients and 2 of the asymptomatic patients. Noteably, in patients with abnormalities on angiography, the reductions in CVR extended beyond the ischemic lesions identified with MR structural imaging into normal-appearing brain parenchyma. Conclusions— This is the first case series reporting blood oxygen level-dependent MRI CVR in children with cerebrovascular disease. CVR studies performed so far provide information regarding hemodynamic compromise, which complements traditional clinical assessment and structural imaging.

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Section: Discussionmentioning

confidence: 98%

Measurement of Cerebrovascular Reactivity in Pediatric Patients With Cerebral Vasculopathy Using Blood Oxygen Level-Dependent MRI

Han

Mikulis

Mardimae

et al. 2011

Stroke

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“…Noninvasive imaging modalities such as perfusion MR imaging, single-photon emission CT, and positron-emission tomography can demonstrate secondary hemodynamic changes. [1][2][3][4]12,[21][22][23][24][25][26][27] However, these methods show only overall cerebral perfusion changes and cannot directly visualize fine parenchymal neovascularization itself following the operation.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Assessment of Neovascularization after Indirect Bypass Surgery: Color-Coded Digital Subtraction Angiography in Pediatric Moyamoya Disease

Cho

Cheon

Kim

et al. 2015

American Journal of Neuroradiology

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“…Quantification of CVR using basal/acetazolamide stress SPECT has been reported previously using ROI or SPAM [8,10]. Moreover, objective image quantification using SPAM has been widely studied in PET data such as 18 F-FP-CIT PET for dopamine transporter imaging [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, objective image quantification using SPAM has been widely studied in PET data such as 18 F-FP-CIT PET for dopamine transporter imaging [18,19]. Although SPAMbased quantification provided the objective parameters, the previous methods were descriptive and did not preserve anatomical information [8,10]. Furthermore, a relatively small sized regional decreased CVR could not be assessed using a SPAM-based descriptive parameter.…”

Section: Discussionmentioning

confidence: 99%

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Parametric Cerebrovascular Reserve Images Using Acetazolamide 99mTc-HMPAO SPECT: A Feasibility Study of Quantitative Assessment

Choi

Yoo

Cheon

et al. 2013

Nucl Med Mol Imaging

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Purpose Basal/acetazolamide stress 99m Tc-HMPAO singlephoton emission computed tomography (SPECT) has been widely used for evaluation of hemodynamics; however, qualitative and subjective visual assessment of cerebrovascular reserve (CVR) has been performed in clinical settings. The aim of this study was to generate parametric CVR images and evaluate its feasibility of quantification. Methods Basal/acetazolamide stress 99m Tc-HMPAO SPECT data from 17 patients who underwent bypass surgery or percutaneous transluminal angioplasty were used. Spatial normalization was performed and parametric CVR images were generated using relative CVR (rCVR) of each voxel proportional to CVR of the whole brain. Binary parametric maps to show area of relatively reduced CVR were generated also using threshold of rCVR < 90 %. We calculated rCVR of internal carotid artery (ICA) using the parametric CVR images and probabilistic maps for ICA territory. Pre-and postprocedural parametric CVR images were obtained and quantitative rCVRs were compared. The rCVRs were evaluated according to visual grades for regional decreased CVR. Results Postprocedural rCVR obtained from parametric CVR images increased significantly from preprocedural rCVR. The rCVR was significantly correlated with visual grades of reduced CVR for each side of ICA territories.Conclusions We generated parametric CVR images for basal/acetazolamide stress 99m Tc-HMPAO SPECT. As a quantitative measurement, rCVR obtained from the parametric image was feasibly assessed hemodynamic abnormalities with preserved anatomical information.

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Prediction of the Clinical Outcome of Pediatric Moyamoya Disease With Postoperative Basal/Acetazolamide Stress Brain Perfusion SPECT After Revascularization Surgery

Cited by 107 publications

References 21 publications

Measurement of Cerebrovascular Reactivity in Pediatric Patients With Cerebral Vasculopathy Using Blood Oxygen Level-Dependent MRI

Measurement of Cerebrovascular Reactivity in Pediatric Patients With Cerebral Vasculopathy Using Blood Oxygen Level-Dependent MRI

Quantitative Assessment of Neovascularization after Indirect Bypass Surgery: Color-Coded Digital Subtraction Angiography in Pediatric Moyamoya Disease

Parametric Cerebrovascular Reserve Images Using Acetazolamide 99mTc-HMPAO SPECT: A Feasibility Study of Quantitative Assessment

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