Revascularization Evaluation in Adult-Onset Moyamoya Disease after Bypass Surgery: Superselective Arterial Spin Labeling Perfusion MRI Compared with Digital Subtraction Angiography

Radiology ◽  
2020 ◽  
Vol 297 (3) ◽  
pp. 630-637
Author(s):  
Inpyeong Hwang ◽  
Won-Sang Cho ◽  
Roh-Eul Yoo ◽  
Koung Mi Kang ◽  
Dong Hyun Yoo ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Moyamoya Disease ◽  
Arterial Spin Labeling ◽  
Bypass Surgery ◽  
Spin Labeling ◽  
Perfusion Mri ◽  
Digital Subtraction ◽  
Adult Onset

Arterial Spin Labeling Magnetic Resonance Imaging Can Identify the Occlusion Site and Collateral Perfusion in Patients with Acute Ischemic Stroke: Comparison with Digital Subtraction Angiography

2019 ◽  
Vol 48 (1-2) ◽  
pp. 70-76 ◽  
Author(s):  
Yoichi Morofuji ◽  
Nobutaka Horie ◽  
Yohei Tateishi ◽  
Minoru Morikawa ◽  
Susumu Yamaguchi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Digital Subtraction Angiography ◽  
Arterial Spin Labeling ◽  
Spin Labeling ◽  
Collateral Flow ◽  
Digital Subtraction ◽  
Resonance Imaging

Background and Objectives: Determining the occlusion site and collateral blood flow is important in acute ischemic stroke. The purpose of the current study was to test whether arterial spin labeling (ASL) magnetic resonance imaging (MRI) could be used to identify the occlusion site and collateral perfusion, using digital subtraction angiography (DSA) as a gold standard. Method: Data from 521 consecutive patients who presented with acute ischemic stroke at our institution from January 2012 to September 2014 were retrospectively reviewed. Image data were included in this study if: (1) the patient presented symptoms of acute ischemic stroke; (2) MRI was performed within 24 h of symptom onset; and (3) DSA following MRI was performed (n = 32 patients). We defined proximal intra-arterial sign (IAS) on ASL as enlarged circular or linear bright hyperintense signal within the occluded artery and distal IAS as enlarged circular or linear bright hyperintense signals within arteries inside or surrounding the affected region. The presence or absence of the proximal IAS and distal IAS were assessed, along with their inter-rater agreement and consistency with the presence of occlusion site and collateral flow on DSA images. Results: The sensitivity and specificity for identifying occlusion site with ASL were 82.8 and 100%, respectively. Those for identifying collateral flow with ASL were 96.7 and 50%, respectively. The inter-rater reliability was excellent for proximal IAS (κ = 0.92; 95% CI 0.76–1.00) and substantial for distal IAS detection (κ = 0.78; 95% CI 0.38–1.00). Conclusions: Proximal IAS and distal IAS on ASL imaging can provide important diagnostic clues for the detection of arterial occlusion sites and collateral perfusion in patients with acute ischemic stroke.

scholarly journals Utility of arterial spin labeling perfusion magnetic resonance imaging in prediction of angiographic vascularity of meningiomas

2016 ◽  
Vol 125 (3) ◽  
pp. 536-543 ◽  
Author(s):  
Roh-Eul Yoo ◽  
Tae Jin Yun ◽  
Young Dae Cho ◽  
Jung Hyo Rhim ◽  
Koung Mi Kang ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Arterial Spin Labeling ◽  
Characteristic Curve ◽  
Tissue Perfusion ◽  
Spin Labeling ◽  
Perfusion Magnetic Resonance Imaging ◽  
Digital Subtraction ◽  
Grading Scale ◽  
The Mean ◽  
Contrast Media Administration

OBJECTIVE Arterial spin labeling perfusion-weighted imaging (ASL-PWI) enables quantification of tissue perfusion without contrast media administration. The aim of this study was to explore whether cerebral blood flow (CBF) from ASL-PWI can reliably predict angiographic vascularity of meningiomas. METHODS Twenty-seven patients with intracranial meningiomas, who had undergone preoperative ASL-PWI and digital subtraction angiography prior to resection, were included. Angiographic vascularity was assessed using a 4-point grading scale and meningiomas were classified into 2 groups: low vascularity (Grades 0 and 1; n = 11) and high vascularity (Grades 2 and 3; n = 16). Absolute CBF, measured at the largest section of the tumor, was normalized to the contralateral gray matter. Correlation between the mean normalized CBF (nCBF) and angiographic vascularity was determined and the mean nCBF values of the 2 groups were compared. Diagnostic performance of the nCBF for differentiating between the 2 groups was assessed. RESULTS The nCBF had a significant positive correlation with angiographic vascularity (ρ = 0.718; p < 0.001). The high-vascularity group had a significantly higher nCBF than the low-vascularity group (3.334 ± 2.768 and 0.909 ± 0.468, respectively; p = 0.003). At the optimal nCBF cutoff value of 1.733, sensitivity and specificity for the differential diagnosis of the 2 groups were 69% (95% CI 41%–89%) and 100% (95% CI 72%–100%), respectively. The area under the receiver operating characteristic curve was 0.875 (p < 0.001). CONCLUSIONS ASL-PWI may provide a reliable and noninvasive means of predicting angiographic vascularity of meningiomas. It may thus assist in selecting potential candidates for preoperative digital subtraction angiography and embolization in clinical practice.

scholarly journals Planning-free cerebral blood flow territory mapping in patients with intracranial arterial stenosis

2016 ◽  
Vol 37 (6) ◽  
pp. 1944-1958 ◽  
Author(s):  
Daniel F Arteaga ◽  
Megan K Strother ◽  
L Taylor Davis ◽  
Matthew R Fusco ◽  
Carlos C Faraco ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Digital Subtraction Angiography ◽  
Gold Standard ◽  
Arterial Spin Labeling ◽  
Spin Labeling ◽  
Circle Of Willis ◽  
Atherosclerotic Disease ◽  
Digital Subtraction ◽  
Intracranial Atherosclerotic Disease

A noninvasive method for quantifying cerebral blood flow and simultaneously visualizing cerebral blood flow territories is vessel-encoded pseudocontinuous arterial spin labeling MRI. However, obstacles to acquiring such information include limited access to the methodology in clinical centers and limited work on how clinically acquired vessel-encoded pseudocontinuous arterial spin labeling data correlate with gold-standard methods. The purpose of this work is to develop and validate a semiautomated pipeline for the online quantification of cerebral blood flow maps and cerebral blood flow territories from planning-free vessel-encoded pseudocontinuous arterial spin labeling MRI with gold-standard digital subtraction angiography. Healthy controls (n = 10) and intracranial atherosclerotic disease patients (n = 34) underwent 3.0 T MRI imaging including vascular (MR angiography) and hemodynamic (cerebral blood flow-weighted arterial spin labeling) MRI. Patients additionally underwent catheter and/or CT angiography. Variations in cross-territorial filling were grouped according to diameters of circle of Willis vessels in controls. In patients, Cohen’s k-statistics were computed to quantify agreement in perfusion patterns between vessel-encoded pseudocontinuous arterial spin labeling and angiography. Cross-territorial filling patterns were consistent with circle of Willis anatomy. The intraobserver Cohen's k-statistics for cerebral blood flow territory and digital subtraction angiography perfusion agreement were 0.730 (95% CI = 0.593–0.867; reader one) and 0.708 (95% CI = 0.561–0.855; reader two). These results support the feasibility of a semiautomated pipeline for evaluating major neurovascular cerebral blood flow territories in patients with intracranial atherosclerotic disease.

scholarly journals Multi-delay arterial spin labeling perfusion MRI in moyamoya disease–comparison with CT perfusion imaging

2014 ◽  
Vol 24 (5) ◽  
pp. 1135-1144 ◽  
Author(s):  
Rui Wang ◽  
Songlin Yu ◽  
Jeffry R. Alger ◽  
Zhentao Zuo ◽  
Juan Chen ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Perfusion Imaging ◽  
Arterial Spin Labeling ◽  
Ct Perfusion ◽  
Spin Labeling ◽  
Perfusion Mri ◽  
Ct Perfusion Imaging
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