Article
Power Doppler assessment of indirect revascularization in childhood Moyamoya disease
Power-Doppler-Untersuchungen zur Abschätzung der indirekten Revaskularisierung bei kindlicher Moyamoya-Erkrankung
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Published: | April 23, 2004 |
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Outline
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Objective
Moyamoya disease mainly affects young children and leads to chronic ischemia and stroke due to progressive stenosis or occlusion of the terminal portions of the internal carotid artery. One of the potential treatment options is indirect revascularization using encephalo-myo-synangiosis (EMS). Standard follow-up of this procedure to assess neoangiogenesis includes repeat conventional angiography (CA). We studied whether non-invasive transcranial Power Doppler imaging (PDI) could provide all the information needed to be an alternative to post-surgical conventional angiography.
Methods
Seven symptomatic children (4 boys, 3 girls) suffering from moyamoya disease, who underwent combined (direct and indirect) revascularization procedures, were examined with CA and PDI to assess the extent of indirect revascularization (EMS) in the post-operative course. The visual grading of EMS function was assessed with CA and PDI at variable dates within 24 months post surgery. According to the imaging properties of CA and PDI, intracranial vessel opacification via EMS function was classified as: absent, moderate and extensive for both methods. Examiners were blinded to the result of the classification of the other procedure.
Results
On follow-up investigations, 13 hemispheres were studied. The visual grading of indirect revascularization (EMS) revealed good and significant agreement between CA and PDI (Spearman rank coefficient of correlation r=0.87; p<0.001).
Conclusions
Our pilot study shows that transcranial PDI may be a valid non-invasive, alternative to CA in evaluating indirect revascularization.