Title

Imaging of cerebrovascular reserve and oxygenation in Moyamoya disease

Document Type

Journal Article

Publication Date

1-1-2017

Journal

Journal of Cerebral Blood Flow and Metabolism

Volume

37

Issue

4

DOI

10.1177/0271678X16651088

Keywords

Cerebrovascular reserve; Moyamoya; Oxygenation; R2′; Transverse relaxation

Abstract

© Author(s) 2016. This study aimed to determine whether measurements of cerebrovascular reserve and oxygenation, assessed with spin relaxation rate R2′, yield similar information about pathology in pre-operative Moyamoya disease patients, and to assess whether R2′ is a better measure of oxygenation than other proposed markers, such as R2* and R2. Twenty-five preoperative Moyamoya disease patients were scanned at 3.0T with acetazolamide challenge. Cerebral blood flow mapping with multi-delay arterial spin labeling, and R2*, R2, and R2′ mapping with Gradient-Echo Sampling of Free Induction Decay and Echo were performed. No baseline cerebral blood flow difference was found between angiographically abnormal and normal regions (49±12 vs. 48±11 mL/100 g/min, p=0.44). However, baseline R2′ differed between these regions (3.2±0.7 vs. 2.9±0.6 s-1, p<0.001), indicating reduced oxygenation in abnormal regions. Cerebrovascular reserve was lower in angiographically abnormal regions (21±38 vs. 41±26%, p=0.001). All regions showed trend toward significantly improved oxygenation post-acetazolamide. Regions with poorer cerebrovascular reserve had lower baseline oxygenation (Kendall’s τ=-0.24, p=0.003). A number of angiographically abnormal regions demonstrated preserved cerebrovascular reserve, likely due to the presence of collaterals. Finally, of the concurrently measured relaxation rates, R2′ was superior for oxygenation assessment.

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