Hyun-Hae Cho MD, Presenter: Nothing to Disclose

Jung-Eun Cheon MD, Abstract Co-Author: Nothing to Disclose

Younghun Choi MD, Abstract Co-Author: Nothing to Disclose

In-One Kim MD, Abstract Co-Author: Nothing to Disclose

Woo Sun Kim MD, Abstract Co-Author: Nothing to Disclose

So Mi Lee MD, Abstract Co-Author: Nothing to Disclose

Seung Ki Kim, Abstract Co-Author: Nothing to Disclose

Su-Mi Shin MD, Abstract Co-Author: Nothing to Disclose

Ji Young Kim MD, Abstract Co-Author: Nothing to Disclose

Sun Kyoung You MD, Abstract Co-Author: Nothing to Disclose

To quantitatively assess the neovascularization after the bypass surgery in children with Moyamoya disease (MMD), using ‘syngo iFlow’ software.

From August 2012 to March 2014, a total of 33 pediatric MMD patients (14 male and 19 female, mean age 8.0 years, range 3~19 years) underwent conventional transfemoral cerebral angiography (TFCA) before and after the indirect revascularization surgery. From the syngo iFlow color-coded images from lateral ICA, ECA and CCA angiograms taken pre- and post-operatively, time-signal intensity curves were generated at the regions-of-interest (ROI) corresponding to the EDAS surgical flap sites. Time-to-peak (TTP) and area-under the curve (AUC) values were obtained from the time-intensity curves. These TTP and AUC values were adjusted for those of time-intensity curves at the input arteries. Changes in adjusted TTP and AUC values at CCA and changes in adjusted AUC values at ICA and ECA angiograms after the surgery were compared across the postoperative clinical outcome scores (4-point scale, 4=excellent, 3=good, 2=fair and 1=poor) and Mathushima’s angiographic revascularization scores (3-point scale, 3 = good, 2 = fair and 1 = poor) by using the Jonckheere-Terpstra test for ordered alternatives.

Adjusted TTP decreased significantly after revasculariziation surgery at CCA angiogram. And the difference of pre and post-operative adjusted TTP at CCA angiogram were significantly different for the clinical outcome groups (p=.002). Adjusted AUC values at CCA angiogram (p<.001) and ECA angiogram (p<.001) increased significantly after surgery. Changes in adjusted AUCs at ICA angiograms showed no significant difference between the clinical outcome groups. Changes in adjusted TTPs (p =.010) and AUCs at CCA angiograms (p<.001) and AUCs at ECA angiograms (p<.001) were also significantly different for the revascularization score groups.

Postoperative changes in quantitative perfusion values obtained with ‘syngo iFlow’ software showed significant correlation with clinical and angiographic scores. These values can be used as objective parameters for evaluating the post-operative neovascularization status in children with MMD.

With ‘syngo iFlow’ software, we can provide the quantitative parameters for the neovascularization status and these values can be used as objective predictors of the clinical outcomes.

Cho, H, Cheon, J, Choi, Y, Kim, I, Kim, W, Lee, S, Kim, S, Shin, S, Kim, J, You, S, Quantification of Cerebral Neovascularization after Indirect Revascularization Surgery in Childhood Moyamoya Disease: Correlation with Clinical Outcomes.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045739.html