Purpose

Patients with Moyamoya Angiopathy (MMA) require hemodynamic evaluation to assess the risk of stroke. Assessment of cerebral blood flow with [¹⁵O]water PET and acetazolamide challenge is the diagnostic standard for the evaluation of the cerebral perfusion reserve (CPR). Estimation of the cerebrovascular reactivity (CVR) by use of breath-hold-triggered fMRI (bh-fMRI) as an index of CPR has been proposed as a reliable and more readily available approach. Recent findings suggest the use of resting-state fMRI (rs-fMRI) which requires minimum patient compliance. The aim of this study was to compare rs-fMRI to bh-fMRI and [¹⁵O]water PET in patients with MMA.

Methods

Patients with MMA underwent rs-fMRI and bh-fMRI in the same MRI session. Maps of the CVR gained by both modalities were compared retrospectively by calculating the correlation between the mean CVR of 12 volumes of interest. Additionally, the rs-maps of a subgroup of patients were compared to CPR-maps gained by [¹⁵O]water PET.

Results

The comparison of the rs-maps and the bh-maps of 24 patients revealed a good correlation (Pearson’s r = 0.71 ± 0.13; preoperative patients: Pearson’s r = 0.71 ± 0.17; postoperative patients: Pearson’s r = 0.71 ± 0.11). The comparison of 7 rs-fMRI data sets to the corresponding [¹⁵O]water PET data sets also revealed a high level of agreement (Pearson’s r = 0.80 ± 0.19).

Conclusion

The present analysis indicates that rs-fMRI might be a promising non-invasive method with almost no patient cooperation needed to evaluate the CVR. Further prospective studies are required.

中文翻译：

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烟雾病血管病患者的血流动力学评估：静息状态 fMRI 与屏气 fMRI 和 [15O] 水 PET 的比较

目的

烟雾病血管病 (MMA) 患者需要进行血流动力学评估以评估中风风险。用 [ ¹⁵ O] 水 PET 和乙酰唑胺激发评估脑血流是评估脑灌注储备 (CPR) 的诊断标准。通过使用屏气触发功能磁共振成像 (bh-fMRI) 作为 CPR 的指标来估计脑血管反应性 (CVR) 已被提议作为一种可靠且更容易获得的方法。最近的研究结果表明使用静息状态功能磁共振成像 (rs-fMRI) 需要最低的患者依从性。本研究的目的是在 MMA 患者中比较 rs-fMRI 与 bh-fMRI 和 [ ^{15 O] 水 PET。}

方法

MMA 患者在同一 MRI 会话中接受了 rs-fMRI 和 bh-fMRI。通过计算 12 个感兴趣体积的平均 CVR 之间的相关性，对两种方式获得的 CVR 图进行了回顾性比较。此外，将患者亚组的 rs-map 与 [ ¹⁵ O] 水 PET 获得的 CPR-map 进行比较。

结果

24 名患者的 rs-map 和 bh-map 的比较显示出良好的相关性（Pearson's r  = 0.71 ± 0.13；术前患者：Pearson's r  = 0.71 ± 0.17；术后患者：Pearson's r  = 0.71 ± 0.11）。7 个 rs-fMRI 数据集与相应的 [ ¹⁵ O] 水 PET 数据集的比较也显示出高度一致（Pearson 的r  = 0.80 ± 0.19）。

结论

目前的分析表明，rs-fMRI 可能是一种很有前途的非侵入性方法，几乎​​不需要患者合作来评估 CVR。需要进一步的前瞻性研究。