Preliminary Applications of 3D-pCASL and DCE-MRI in Evaluating Collateral Circulaton and Cerebralvascular Permeability in Moyamoya Disease

Objective To explore the application of DCE-( dynamic contrast enhancement) and 3D-pC ASL( pseudocontinuous arterial spin labeling) MRI in the quantitive evaluation of cerebrovascular collateral circulation and permeability in Moyamoya disease( MMD). Methods A prospective analysis of DCE- and 3D-pC ASL MRI was performed in 17 patients with MMD confirmed by DSA and / or 3D MRA. According to the feeding distribution of the anterior、middle and posterior cerebral artery,10 regions of interest from primitive CBF( cerebral blood flow) labeling maps of 3D-pC ASL MRI were drawn manually on each section through the level of basal ganglia,each region was scored with 0,1,2 and 3,respectively,the corresponding CBF values in the CBF map,and Ktransvalues in Ktransmap were measured. All the 170 regions were classified into 0,1,2 and 3 groups according to the scoring results. The statistical tests of ANOVA and Kruskal-Wallis H were used to compare CBF and Ktransvalues among 0- 3 groups,respectively.( P values of less than 0. 05 were considered to be significant). Results Significant difference was observed among 0- 3 groups with the CBF values of 32. 7 ±10. 68,39. 11 ± 15. 13,57. 08 ± 13. 99 和 54. 84 ± 15. 45,respectively( F = 247. 248,P < 0. 001); there were no significant difference in the comparisons of groups of 0 vs 1 and 2 vs 3,in contrast,other comparisons between groups were significant( all P < 0. 001). No significant difference of Ktransvalues were observed among 0- 3 groups with Ktransvalues of0. 021( 0. 007,0. 028),0. 019( 0. 014,0. 038),0. 020( 0. 009,039) and 0. 024( 0. 020,0. 038)( χ2= 3. 128,P =0. 372). Meanwhile,the increased values of Ktranswere observed in the three regions of two cases with subacute infarction and four regions of one case with TIA than other regions. Conclusion The combination of 3D-pC ASL and DCE-MRI is a feasible method to quantitively evaluate cerebrovascular perfusion and permeability in MMD.