gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

CO2-triggered BOLD MRI for the hemodynamic evaluation of patients with moyamoya disease

CO2-getriggerte BOLD MRT Bildgebung für die hämodynamische Evaluation von Patienten mit Moyamoya

Meeting Abstract

  • presenting/speaker Constantin Roder - Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und Bypasschirurgie, Tübingen, Deutschland
  • Till-Karsten Hauser - Universitätsklinikum Tübingen, Neuroradiologie, Tübingen, Deutschland
  • Ulrike Ernemann - Universitätsklinikum Tübingen, Neuroradiologie, Tübingen, Deutschland
  • Philipp Meyer - Universitätsklinikum Freiburg, Nuklearmedizin, Freiburg, Deutschland
  • Marcos Tatagiba - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Nadia Khan - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland; Kinderspital Zürich, Moyamoya Zentrum, Zürich, Switzerland; Universitätsklinikum Tübingen, Zentrum für Moyamoya und Bypasschirurgie, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV138

doi: 10.3205/19dgnc153, urn:nbn:de:0183-19dgnc1537

Veröffentlicht: 8. Mai 2019

© 2019 Roder et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Patients with Moyamoya Disease (MMD) need hemodynamic evaluation of vascular territories at risk of stroke. Today’s investigative standards include H215O PET/CT with pharmacological challenges with acetazolamide (ACZ). Recent developments suggest that CO2-triggered blood-oxygen-level-dependent (BOLD) functional MRI might provide comparable results to current standard methods for evaluation of territorial hemodynamics, while being a more widely available and easily implementable method. This study examines results of a newly developed quantifiable analysis algorithm for CO2-triggered BOLD MRI in Moyamoya patients and correlates the results with H215O PET/CT with ACZ challenge to assess comparability between both modalities.

Methods: CO2-triggered BOLD MRI was performed and compared to H215O PET/CT with ACZ challenge in patients with angiographically proven MMD. Images of both modalities were analyzed retrospectively in a blinded, standardized fashion by visual inspection, as well as with a semi-quantitative analysis using stimuli-induced approximated regional perfusion changes with reference to cerebellum.

Results: 20 consecutive patients fulfilled the inclusion criteria, a total of 160 vascular territories were analyzed retrospectively. Visual analysis (4-step visual rating system) of standardized, color-coded cerebrovascular reserve/reactivity maps showed a very strong correlation (Spearman’s rho=0.9, P<0.001) between both modalities. Likewise, comparison of approximated regional perfusion changes across vascular territories (normalized to cerebellar change) reveal a highly significant correlation between both methods (Pearson’s r=0.71, P<0.001).

Conclusion: The present analysis indicates that CO2-triggered BOLD MRI is a very promising, reliable tool for the hemodynamic evaluation of MMD patients with results comparable to those seen in H215O PET/CT with ACZ challenge. It therefore holds future potential in becoming a routine examination in the pre- and postoperative evaluation of MMD patients after further prospective evaluation.