Skip to main content

Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya.

Publication ,  Journal Article
Rao, VL; Prolo, LM; Santoro, JD; Zhang, M; Quon, JL; Jin, M; Iyer, A; Yedavalli, V; Lober, RM; Steinberg, GK; Yeom, KW; Grant, GA
Published in: Stroke
April 2022

BACKGROUND: Cerebrovascular reserve (CVR) inversely correlates with stroke risk in children with Moyamoya disease and may be improved by revascularization surgery. We hypothesized that acetazolamide-challenged arterial spin labeling MR perfusion quantifies augmentation of CVR achieved by revascularization and correlates with currently accepted angiographic scoring criteria. METHODS: We retrospectively identified pediatric patients with Moyamoya disease or syndrome who received cerebral revascularization at ≤18 years of age between 2012 and 2019 at our institution. Using acetazolamide-challenged arterial spin labeling, we compared postoperative CVR to corresponding preoperative values and to postoperative perfusion outcomes classified by Matsushima grading. RESULTS: In this cohort, 32 patients (17 males) with Moyamoya underwent 29 direct and 16 indirect extracranial-intracranial bypasses at a median 9.7 years of age (interquartile range, 7.6-15.7). Following revascularization, median CVR increased within the ipsilateral middle cerebral artery territory (6.9 mL/100 g per minute preoperatively versus 16.5 mL/100 g per minute postoperatively, P<0.01). No differences were observed in the ipsilateral anterior cerebral artery (P=0.13) and posterior cerebral artery (P=0.48) territories. Postoperative CVR was higher in the ipsilateral middle cerebral artery territories of patients who achieved Matsushima grade A perfusion, in comparison to those with grades B or C (25.8 versus 17.5 mL, P=0.02). The method of bypass (direct or indirect) did not alter relative increases in CVR (8 versus 3.8 mL/100 g per minute, P=0.7). CONCLUSIONS: Acetazolamide-challenged arterial spin labeling noninvasively quantifies augmentation of CVR following surgery for Moyamoya disease and syndrome.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

April 2022

Volume

53

Issue

4

Start / End Page

1354 / 1362

Location

United States

Related Subject Headings

  • Spin Labels
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Moyamoya Disease
  • Male
  • Humans
  • Female
  • Child
  • Cerebrovascular Circulation
  • Cerebral Revascularization
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Rao, V. L., Prolo, L. M., Santoro, J. D., Zhang, M., Quon, J. L., Jin, M., … Grant, G. A. (2022). Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya. Stroke, 53(4), 1354–1362. https://doi.org/10.1161/STROKEAHA.121.036616
Rao, Vaishnavi L., Laura M. Prolo, Jonathan D. Santoro, Michael Zhang, Jennifer L. Quon, Michael Jin, Aditya Iyer, et al. “Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya.Stroke 53, no. 4 (April 2022): 1354–62. https://doi.org/10.1161/STROKEAHA.121.036616.
Rao VL, Prolo LM, Santoro JD, Zhang M, Quon JL, Jin M, et al. Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya. Stroke. 2022 Apr;53(4):1354–62.
Rao, Vaishnavi L., et al. “Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya.Stroke, vol. 53, no. 4, Apr. 2022, pp. 1354–62. Pubmed, doi:10.1161/STROKEAHA.121.036616.
Rao VL, Prolo LM, Santoro JD, Zhang M, Quon JL, Jin M, Iyer A, Yedavalli V, Lober RM, Steinberg GK, Yeom KW, Grant GA. Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya. Stroke. 2022 Apr;53(4):1354–1362.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

April 2022

Volume

53

Issue

4

Start / End Page

1354 / 1362

Location

United States

Related Subject Headings

  • Spin Labels
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Moyamoya Disease
  • Male
  • Humans
  • Female
  • Child
  • Cerebrovascular Circulation
  • Cerebral Revascularization