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• Clinical Article •
Evaluating blood flow status after revascularization in patients with moyamoya disease by using TOF-MRA, 3D-ASL and territory ASL
SHI Chuanying  CHEN Jun  ZHANG Chuanchen  WANG Jipeng  XIAO Yilei  LUAN Jixin  SU Daoqing 

Cite this article as: Shi CY, Chen J, Zhang CC, et al. Evaluating blood flow status after revascularization in patients with moyamoya disease by using TOF-MRA, 3D-ASL and territory ASL. Chin J Magn Reson Imaging, 2020, 11(9): 735-740. DOI:10.12015/issn.1674-8034.2020.09.004.


[Abstract] Objective: To investigate the value of time-of-flight MR angiography (TOF-MRA), three-dimensional arterial spin labeling (3D-ASL) and territory ASL (T-ASL) in monitoring blood flow status of patients with moyamoya disease after revascularization.Materials and Methods: This retrospective study was conducted in 19 hemispheres of 18 patients with moyamoya disease who underwent revascularization operation in March 2017 to March 2019. TOF-MRA, 3D-ASL and T-ASL were performed pre- and postoperatively, and the postoperative follow-up time was 3.5—14.5 months. TOF-MRA scan was used to observe the postoperative intracranial-external communication artery. Base on Alberta Stroke Programme Early Computed Tomography Score (ASPECT) system, 3D-ASL was used to compare pre- and postoperative cerebral blood flow (CBF) and relative cerebral blood flow (rCBF). T-ASL was used to calculate the volume of reconstruction area (RA) and the perfusion of deep brain structures by the external carotid artery (ECA) on the operated side.Results: TOF-MRA showed that postoperative intracranial-external communication arteries included single, thick bypass vessels (73.7%, 14/19) and clustered, thin new collateral vessels (57.9%, 10/19). Before and after surgery, ASL-CBF was (41.4±19.3) ml/100 g•min and (48.9±15.1) ml/100 g•min), and rCBF was 0.88±0.34 and 1.08±0.26 respectively, with statistically significant differences (P<0.01). RA volume ranges from 4.85 to 370.91 ml, with a median of 109.72 ml. Perfusion of deep brain structures by ECA showed that 15.8% (3/19) of RA region covered deep brain structures such as ipsilateral basal ganglia and thalamus, 63.2% (12/19) of RA region covered ipsilateral deep cerebral cortex, and 21.1% (4/19) of RA region covered contralateral deep cerebral cortex. Nine of the 10 patients with RA volume greater than 100 ml showed both bypass arteries and clustered collateral arteries, while 9 patients with RA volume less than 100 ml showed only bypass arteries or only sparse collateral arteries.Conclusions: The combined application of TOF-MRA, 3D-ASL and T-ASL can monitor the intracranial-external communication artery condition, identify the CBF changes, calculate RA volume and observe coverage area objectively after revascularization of moyamoya disease, and it is valuable to monitoring blood flow status after revascularization in patients with moyamoya disease.
[Keywords] moyamoya disease；revascularization；arterial spin labeling

SHI Chuanying Department of Radiology, People's Hospital of Liaocheng City, Liaocheng, 252000, China

CHEN Jun Department of Radiology, People's Hospital of Liaocheng City, Liaocheng, 252000, China

ZHANG Chuanchen Department of Radiology, People's Hospital of Liaocheng City, Liaocheng, 252000, China

WANG Jipeng Department of Radiology, People's Hospital of Liaocheng City, Liaocheng, 252000, China

XIAO Yilei Department of Neurosurgery, People's Hospital of Liaocheng City, Liaocheng, 252000, China

LUAN Jixin Department of Radiology, People's Hospital of Liaocheng City, Liaocheng, 252000, China

SU Daoqing* Department of Neurosurgery, People's Hospital of Liaocheng City, Liaocheng, 252000, China

*Correspondence to: Su DQ, E-mail: daoqingsu@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article is supported by the National Natural Science Foundation of China No. 81701159 Science Foundation of Liaocheng People’s Hospital No. LYQN201924
Received  2020-04-06
Accepted  2020-07-25
DOI: 10.12015/issn.1674-8034.2020.09.004
Cite this article as: Shi CY, Chen J, Zhang CC, et al. Evaluating blood flow status after revascularization in patients with moyamoya disease by using TOF-MRA, 3D-ASL and territory ASL. Chin J Magn Reson Imaging, 2020, 11(9): 735-740. DOI:10.12015/issn.1674-8034.2020.09.004.

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