Original ArticleClinical assessment of cerebral hemodynamics in Moyamoya disease via multiple inversion time arterial spin labeling and dynamic susceptibility contrast-magnetic resonance imaging: A comparative study

Background and purposeFor Moyamoya disease (MMD) patients, accurate hemodynamic assessment is critical for treatment selection and efficacy assessment. This study aims to investigate the clinical value of mTI-ASL in assessing the cerebral hemodynamics of MMD patients before and after revascularization, relative to DSC-MRI.Materials and methodsForty-one MMD patients underwent mTI-ASL and DSC-MRI during blood perfusion. Quantitative parameters for the bilateral supply vessels of middle and anterior cerebral arteries, including DSC-TTP, DSC-CBF, ASL-BAT, and ASL-CBF were measured. The correlations between DSC-ΔTTP (TTPhemisphere - TTPbrainstem) and ASL-ΔBAT (BAThemisphere - BATbrainstem) and between DSC-CBF and ASL-CBF were determined. The consistency between the two techniques in assessing the cerebral ischemic state before and after revascularization was analyzed.ResultsDSC-ΔTTP and ASL-ΔBAT (r = 0.36, P < 0.001) and DSC-CBF and ASL-CBF (r = 0.32, P < 0.001) exhibited significant correlation on 824 regions of interest (ROIs) and similar numbers of ischemic areas on 902 ROIs (κ = 0.82, P < 0.001). The ischemic scores were 3.17 ± 3.02 and 2.98 ± 2.81 by DSC-MRI and ASL-MRI, respectively (ICC = 0.92). For 15 surgically treated patients, the scores for blood perfusion improvement on the operated side were 3.13 ± 1.68 and 3.27 ± 1.33 with DSC-TTP and ASL-BAT, respectively (ICC = 0.94).ConclusionCompared to DSC-MRI, mTI-ASL can assess the cerebral hemodynamics in MMD and evaluate ischemic state before revascularization and ischemia reduction after revascularization effectively. And mTI-ASL is more advantageous because it does not require contrast agents.