TY - JOUR

T1 - White and Gray Matter Perfusion in Children with Moyamoya Angiopathy after Revascularization Surgery

AU - Filimonova, Elena

AU - Martirosyan, Azniv

AU - Ovsiannikov, Konstantin

AU - Pashkov, Anton

AU - Rzaev, Jamil

N1 - © 2023 The Author(s). Published by S. Karger AG, Basel.

PY - 2023/9

Y1 - 2023/9

N2 - INTRODUCTION: Surgical revascularization is very effective in patients with moyamoya angiopathy (MMA) and leads to improvements in cortical perfusion parameters. However, changes in white matter hemodynamics are still underestimated. To date, only a few studies have examined brain perfusion changes within deep white matter after bypass surgery in patients with MMA.METHODS: Ten children with MMA were evaluated using the CT perfusion technique before and after revascularization surgery. Brain perfusion parameters within gray and white matter were compared before and after surgery. The correlations between the perfusion parameters before surgery and the Suzuki stage, as well as between the perfusion parameters and the cognitive scores, were also evaluated.RESULTS: Brain perfusion parameters improved significantly in both gray matter (predominantly due to cerebral blood flow within the anterior circulation, p < 0.01) and white matter (predominantly due to cerebral blood volume within the semiovale centrum, p < 0.001). We revealed that the pattern of improvement in perfusion in white matter differed from the pattern of improvement in perfusion in gray matter. Significant correlations were revealed between the Suzuki stage before surgery and the perfusion parameters within the posterior cerebral artery circulation (adjusted p < 0.05). There were also significant correlations between cognitive scores and brain perfusion parameters in gray matter and white matter (adjusted p < 0.05).CONCLUSIONS: The perfusion parameters of gray matter and white matter in the brain improve differently after bypass surgery in patients with MMA. Different hemodynamics within these compartments could explain this.

AB - INTRODUCTION: Surgical revascularization is very effective in patients with moyamoya angiopathy (MMA) and leads to improvements in cortical perfusion parameters. However, changes in white matter hemodynamics are still underestimated. To date, only a few studies have examined brain perfusion changes within deep white matter after bypass surgery in patients with MMA.METHODS: Ten children with MMA were evaluated using the CT perfusion technique before and after revascularization surgery. Brain perfusion parameters within gray and white matter were compared before and after surgery. The correlations between the perfusion parameters before surgery and the Suzuki stage, as well as between the perfusion parameters and the cognitive scores, were also evaluated.RESULTS: Brain perfusion parameters improved significantly in both gray matter (predominantly due to cerebral blood flow within the anterior circulation, p < 0.01) and white matter (predominantly due to cerebral blood volume within the semiovale centrum, p < 0.001). We revealed that the pattern of improvement in perfusion in white matter differed from the pattern of improvement in perfusion in gray matter. Significant correlations were revealed between the Suzuki stage before surgery and the perfusion parameters within the posterior cerebral artery circulation (adjusted p < 0.05). There were also significant correlations between cognitive scores and brain perfusion parameters in gray matter and white matter (adjusted p < 0.05).CONCLUSIONS: The perfusion parameters of gray matter and white matter in the brain improve differently after bypass surgery in patients with MMA. Different hemodynamics within these compartments could explain this.

KW - Humans

KW - Child

KW - Gray Matter/diagnostic imaging

KW - Moyamoya Disease/diagnostic imaging

KW - Brain/diagnostic imaging

KW - White Matter/diagnostic imaging

KW - Perfusion

KW - Cerebrovascular Circulation/physiology

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85171901692&origin=inward&txGid=ac0f2a827924b13c85f996571ea5285c

UR - https://www.mendeley.com/catalogue/5e2ae609-d5f5-3ba8-8793-d3c0a73cb734/

U2 - 10.1159/000531719

DO - 10.1159/000531719

M3 - Article

C2 - 37379805

VL - 58

SP - 197

EP - 205

JO - Pediatric neurosurgery

JF - Pediatric neurosurgery

SN - 1016-2291

IS - 4

ER -