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Clinical Article
Study of pseudo-continuous arterial spin labeling perfusion MRI on the evaluation of cerebral hemodynamics in patients with hemorrhagic moyamoya disease
WANG Xianwen  WU Fang  LIU Yuehong  WANG Erling  FAN Wentao  ZHANG Xianchang  YAO Zeshan  YANG Qi 

Cite this article as: Wang XW, Wu F, Liu YH, et al. Study of pseudo-continuous arterial spin labeling perfusion MRI on the evaluation of cerebral hemodynamics in patients with hemorrhagic moyamoya disease[J]. Chin J Magn Reson Imaging, 2022, 13(1): 6-10. DOI:10.12015/issn.1674-8034.2022.01.002.


[Abstract] Objective To investigate hemodynamic changes in adult patients with hemorrhagic moyamoya disease based on pseudo-continuous artery spin labeling (pCASL) imaging.Materials and Methods: A total of 32 patients (38 hemispheres) with hemorrhagic or ischemic moyamoya diasease in Xuanwu Hospital were enrolled from December 2016 to April 2019, including 21 hemorrhagic hemispheres and 17 ischemic hemispheres. All patients underwent pCASL exams within 3 months after the onset. Mean perfusion parameters of cerebral blood flow (CBF), pCASL-arterial cerebral blood volume (aCBV) and pCASL-arterial transit time (ATT) derived using pCASL were measured within peripheral region of the lesion, ipsilateral frontal lobe and temporal lobe on the semi-oval layer and positive lesion layer. Inter-group comparison between hemorrhage and infarction was carried out through t-test of two independent samples and Mann-Whitney U test of two independent samples.Results A total of 21 hemorrhagic hemispheres were involved. In the peripheral region of the lesion, mean aCBV, ATT and CBF values were (1.01±0.22) mL/100g, (1.53±0.98) s and (37.88±6.19) mL/ (100 g·min), respectively. In the frontal lobe, mean aCBV, ATT and CBF values were (1.23±0.31) mL/100g, (1.55±0.15) s and (47.03±13.78) mL/(100 g·min), respectively. In the temporal lobe, mean aCBV, ATT and CBF values were (1.28±0.30) mL/100g, (1.54±0.12) s and (51.91±13.96) mL/(100 g·min), respectively. For the 17 ischemic cerebral hemispheres, mean aCBV, ATT and CBF values were (1.11±0.24) mL/100g, (1.46±0.35) s and (49.27±14.13) mL/(100 g·min) in the lesion peripheral region, (1.17±0.30) mL/100g, (1.51±0.37) s and (43.17±14.63) mL/(100 g·min) in the frontal lobe, and (1.21±0.35) mL/100g, (1.50±0.40) s and (49.25±20.85) mL/(100 g·min) in the temporal lobe. Compared with ischemic hemispheres, the hemorrhagic hemispheres showed significantly lower CBF in the peripheral region of the lesion (P<0.05). However, there's no statistical difference between two groups in term of aCBV and ATT. No evident statistical difference was seen in statistics of perfusion parameters of the frontal lobe and temporal lobe.Conclusions Hemorrhagic moyamoya disease has the lower perfusion than ischemic moyamoya. pCASL can detect the grade of blood flow failure in adults with hemorrhagic moyamoya disease, monitor tiny ischemic changes in peripheral frontal and temporal lobes, which can provide a basis for further research on early detection of rebleeding by monitoring hemodynamics.
[Keywords] moyamoya disease;pseudo-continuous arterial spin labeling;hemorrhage;hemodynamics;magnetic resonance imaging

WANG Xianwen1, 2   WU Fang1   LIU Yuehong3   WANG Erling3   FAN Wentao3   ZHANG Xianchang4   YAO Zeshan5   YANG Qi3*  

1 Medical Imaging Department, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

2 Radiology Department, Beijing Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing 100022, China

3 Medical Imaging Department, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

4 MR Collaboration, Siemens Healthcare Ltd., Beijing 100000, China

5 Anlmage Technology (Beijing) Co., Ltd., Beijing 100000, China

YANG Q, E-mail: yangyangqiqi@gmail.com

Conflicts of interest   None.

Received  2021-06-26
Accepted  2021-11-25
DOI: 10.12015/issn.1674-8034.2022.01.002
Cite this article as: Wang XW, Wu F, Liu YH, et al. Study of pseudo-continuous arterial spin labeling perfusion MRI on the evaluation of cerebral hemodynamics in patients with hemorrhagic moyamoya disease[J]. Chin J Magn Reson Imaging, 2022, 13(1): 6-10.DOI:10.12015/issn.1674-8034.2022.01.002

[1]
Research Committee on the Pathology and Treatment of Spontaneous Occlusion of the Circle of Willis. Guidelines for diagnosis and treatment of moyamoya disease (spontaneous occlusion of the circle of Willis)[J]. Neurol Med Chir (Tokyo), 2012, 52(5): 245-266. DOI: 10.2176/nmc.52.245.
[2]
Fan AP, Khalighi MM, Guo J, et al. Identifying Hypoperfusion in Moyamoya Disease With Arterial Spin Labeling and an [15O]-Water Positron Emission Tomography/Magnetic Resonance Imaging Normative Database[J]. Stroke, 2019, 50: 373-380. DOI: 10.1161/STROKEAHA.118.023426.
[3]
Miyamoto S, Yoshimoto T, Hashimoto N, et al. Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial[J]. Stroke, 2014, 45:1415-1421. DOI: 10.1161/STROKEAHA.113.004386.
[4]
Noguchi T, Kawashima M, Irie H, et al. Awterial spin-labeling MR imaging in mayamoya diserse compared with SPECT imaging[J]. Eur J Radiol, 2011, 80(3): e557-e562. DOI: 10.1016/j.ejrad.2011.01.016.
[5]
Qiao PG, Han C, Zuo ZW, et al. Clinical assessment of cerebral hemodynamics in Moyamoya disease Via multiple inversion time arterial spin labeling and dynamic susceptibility contrastmagnetic resonance imaging:a comparative study[J]. J Neuroradiol, 2017, 44(4): 273-280. DOI: 10.1016/j.neurad.2016.12.006.
[6]
Alsop DC, Detre JA, Golay X, et al. Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications:a consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia[J]. Magn Reson Med, 2015, 73(1): 102-116. DOI: 10.1002/mrm.25197.
[7]
Bivard A, Krishnamurthy V, Stanwell P, et al. Arterial spin labeling versus bolus-thacking perfusion in hyperacute stroke[J]. Stroke, 2014, 45(1):127-133. DOI: 10.1161/STROKEAHA.113.003218.
[8]
Lee M, Zaharchuk G, Guzman R, et al. Quantitative Quantitative hemodynamic studies in moyamoya disease: a review[J]. Neurosurg Focus, 2009, 26(4): E5. DOI: 10.3171/2009.1.FOCUS08300.
[9]
Nael K, Meshksar A, Liebeskind DS, et al. Perjprocedural arterial spin labeling and dynamic susceptibility contrast perfusion in detection of cerebral blood flow in patients with acute ischemic syndrome[J]. Stroke, 2013, 44(3): 664-670. DOI: 10.1161/STROKEAHA.112.672956.
[10]
Robert G, Ruth O'G, Nadia K, et al. Arterial spin labelling MRI for assessment of cerebral perfusion in children with moyamoya disease:comparison with dynamic susceptibility contrast MRI[J]. Neuroradiology, 2013, 55(5): 639-647. DOI: 10.1007/s00234-013-1155-8.
[11]
Fan XY, Feng F. Application of arterial spin labeling magnetic resonance imaging in moyamoya disease[J]. Int J Med Radiol, 2019, 42(6): 668-682. DOI: 10.19300/j.2019.Z7301.
[12]
Wang ZY, Huang GF, Chen LY, et al. Combined Surgical revascularization for ischemic Moyamoya disease in adults[J]. Chin J Neurosurg, 2018, 34(7):682-684. DOI: 10.3760/cma.j.issn.1001-2346.2018.07.008.
[13]
Jo KI, Kim MS, Yeon JY, et al. Recurrent bleeding in hemorrhagic moyamoya disease:prognostic implications of the perfusion status[J]. J Korean Neurosurg Soc, 2016, 59(2): 117-121. DOI: 10.3340/jkns.2016.59.2.117.
[14]
Chen JH, Liu DY, Zhang HB, et al. Perioperative nursing observation of adult hemorrhagic Moyamoya disease[J]. Chin Clin Neurosurg, 2018, 23(6): 437-438. DOI: 10.13798/j.issn.1009-153X.2018.06.020.
[15]
Takeshi F, Takahashi JC, Kiyohiro Houkin K, et al. High rebleeding risk associated with choroidal collateral vessels in hemorrhagic moyamoya disease: analysis of a nonsurgical cohort in the Japan Adult Moyamoya Trial[J]. J Neurosurg, 2019, 130(2): 525-530. DOI: 10.3171/2017.9.jns17576.
[16]
Zhong Z, Chen YQ, Guo X, et al. Evaluation of CT perfusion imaging before and after vascular reconstruction in patients with Moyamoya disease[J]. J Pract Radiol, 2018, 34(11): 1765-1768. DOI: 10.3969/j.issn.1002-1671.2018.11.030.
[17]
Guo X, Yuan XX, Chen YQ, et al. CT perfusion in assessment of hemodynamic changes in symptomatic Moyamoya syndrome[J]. J Med Imaging , 2018, 28(9): 1427-1431.
[18]
Qi ZQ. CT perfusion image of surgical effect in patients with hemorrhagic moyamoya disease[J]. Clin Educ of Gen Pract, 2020, 18(5): 427-430. DOI: 10.13558/j.cnki.issn1672-3686.2020.005.012.
[19]
Zhu WJ, Zhang S, Zhang SX, et al. A comparative study of three dimensional arterial spin labeling and dynamic magnetic sensitivity contrast perfusion weighted imaging in evaluating Hemodynamics in adult moyamoya disease patients[J]. Chin J Radiol, 2017, 51(2): 86-90. DOI: 10.3760/cma.j.issn.1005-1201.2017.02.002.
[20]
Chen CY, Deng KX, Qiu J, et al. Evaluation of cerebral perfusion in patients with ischemic and hemorrhagic moyamoya disease by arterial spin labeling[J]. Chin Gen Pract, 2019, 17(12): 2001-2003. DOI: 10.16766/j.cnki.issn.1674-4152.001112.
[21]
Takeshi F, Takahashi JC, Kiyohiro Houkin K, et al. Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial[J]. J Neurosurg Pediatr, 2019, 132(2): 408-414. DOI: 10.3171/2018.10.JNS181139.

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