Novel Method of Calculation of Magnetic Resonance Imaging Perfusion and Comparison of Single versus Double Barrel Superficial Temporal Artery-Middle Cerebral Artery Bypass for Revascularisation in Moya Moya Disease

Moyamoya disease (MMD) is characterized by supraclinoid internal carotid artery narrowing causing cerebral parenchyma to starve. Direct and indirect revascularisation techniques are the treatment norm. We provide a clinicoradiological comparison of single and double barrel superficial temporal arter...

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Vydané v:	World neurosurgery Ročník 181; s. e516 - e523
Hlavní autori:	Manjunath, Niveditha, Dhanakshirur, Rohan Raju, Joshi, Siddharth, Reddy, Nikhila Gunna, Raheja, Amol, Devrajan Sebastian, Leve Joseph, Garg, Ajay, Kalra, Prem Kumar, Suri, Ashish
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Elsevier Inc 01.01.2024
Predmet:	Double barrel bypass Image processing algorithm Moya Moya disease Perfusion analysis Revascularization Single barrel bypass Moya Moya disease AOS MMD MRI CBF HSV MCA Image processing algorithm ROI TIA mRS Single barrel bypass Perfusion analysis DSA Double barrel bypass ASL GUI STA-MCA Revascularization ACA
ISSN:	1878-8750, 1878-8769
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Abstract	Moyamoya disease (MMD) is characterized by supraclinoid internal carotid artery narrowing causing cerebral parenchyma to starve. Direct and indirect revascularisation techniques are the treatment norm. We provide a clinicoradiological comparison of single and double barrel superficial temporal artery to middle cerebral artery (STA-MCA) bypass for MMD. The perfusion in cerebral hemispheres and vessel density in digital subtraction angiography (DSA) have been evaluated using novel algorithms. DSA, arterial spin labeling magnetic resonance imaging methods and Suzuki, Matsushima, Angiographic Outcome Score scales were used to quantify perfusion parameters; modified Rankin Score was used for clinical evaluation. A novel image processing algorithm was designed to perform analysis of arterial spin labeling sequences and compare perfusion. Vessel density was calculated using connected component analysis on thresholded DSA images. Fifty-four hemispheres with MMD underwent STA-MCA bypass 42(77.8%) single barrel and 12 (22.2%) double barrel. Clinical outcome—modified Rankin Score was significant with P < 0.001 in single barrel and P = 0.001 in double barrel groups. The overall Angiographic Outcome Score showed improvement postoperatively (P = 0.032). Perfusion analysis was performed in 20 hemispheres (13 single barrel; 7 double barrel). MCA territories showed significant improvement in single barrel (2.72%, P = 0.0294) and double barrel groups (12.89%, P = 0.025). Vessel density calculated in MCA territory, showed an overall postoperative improvement (P = 1.75 × 10–8). Double barrel STA-MCA bypass clinically as well as radiologically improves perfusion in the ACA as well as MCA territories in MMD. The novel image processing algorithm is an accurate, objective tool to evaluate perfusion in magnetic resonance images and vessel density in DSA images of MMD.
AbstractList	Moyamoya disease (MMD) is characterized by supraclinoid internal carotid artery narrowing causing cerebral parenchyma to starve. Direct and indirect revascularisation techniques are the treatment norm. We provide a clinicoradiological comparison of single and double barrel superficial temporal artery to middle cerebral artery (STA-MCA) bypass for MMD. The perfusion in cerebral hemispheres and vessel density in digital subtraction angiography (DSA) have been evaluated using novel algorithms. DSA, arterial spin labeling magnetic resonance imaging methods and Suzuki, Matsushima, Angiographic Outcome Score scales were used to quantify perfusion parameters; modified Rankin Score was used for clinical evaluation. A novel image processing algorithm was designed to perform analysis of arterial spin labeling sequences and compare perfusion. Vessel density was calculated using connected component analysis on thresholded DSA images. Fifty-four hemispheres with MMD underwent STA-MCA bypass 42(77.8%) single barrel and 12 (22.2%) double barrel. Clinical outcome—modified Rankin Score was significant with P < 0.001 in single barrel and P = 0.001 in double barrel groups. The overall Angiographic Outcome Score showed improvement postoperatively (P = 0.032). Perfusion analysis was performed in 20 hemispheres (13 single barrel; 7 double barrel). MCA territories showed significant improvement in single barrel (2.72%, P = 0.0294) and double barrel groups (12.89%, P = 0.025). Vessel density calculated in MCA territory, showed an overall postoperative improvement (P = 1.75 × 10–8). Double barrel STA-MCA bypass clinically as well as radiologically improves perfusion in the ACA as well as MCA territories in MMD. The novel image processing algorithm is an accurate, objective tool to evaluate perfusion in magnetic resonance images and vessel density in DSA images of MMD.
Author	Dhanakshirur, Rohan Raju Raheja, Amol Kalra, Prem Kumar Manjunath, Niveditha Suri, Ashish Reddy, Nikhila Gunna Joshi, Siddharth Devrajan Sebastian, Leve Joseph Garg, Ajay
Author_xml	– sequence: 1 givenname: Niveditha surname: Manjunath fullname: Manjunath, Niveditha organization: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India – sequence: 2 givenname: Rohan Raju surname: Dhanakshirur fullname: Dhanakshirur, Rohan Raju organization: Amarnath and Shashi Khosla School of Information Technology, Indian Institute of Technology, New Delhi, India – sequence: 3 givenname: Siddharth surname: Joshi fullname: Joshi, Siddharth organization: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India – sequence: 4 givenname: Nikhila Gunna surname: Reddy fullname: Reddy, Nikhila Gunna organization: Department of Neuroimaging and Interventional Neuro-radiology, All India Institute of Medical Sciences, New Delhi, India – sequence: 5 givenname: Amol surname: Raheja fullname: Raheja, Amol organization: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India – sequence: 6 givenname: Leve Joseph surname: Devrajan Sebastian fullname: Devrajan Sebastian, Leve Joseph organization: Department of Neuroimaging and Interventional Neuro-radiology, All India Institute of Medical Sciences, New Delhi, India – sequence: 7 givenname: Ajay surname: Garg fullname: Garg, Ajay organization: Department of Neuroimaging and Interventional Neuro-radiology, All India Institute of Medical Sciences, New Delhi, India – sequence: 8 givenname: Prem Kumar surname: Kalra fullname: Kalra, Prem Kumar organization: Department of Computer Science Engineering, Indian Institute of Technology, New Delhi, India – sequence: 9 givenname: Ashish orcidid: 0000-0002-0464-0860 surname: Suri fullname: Suri, Ashish email: surineuro@gmail.com organization: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Cites_doi	10.1007/s00701-012-1412-3 10.1227/NEU.0b013e3182333c47 10.1007/BF01808612 10.1093/ons/opx119 10.2176/nmc.17pt1.29 10.1038/s41598-020-80036-3 10.1080/01616412.1991.11739976 10.3171/ped.2004.100.2.0142 10.1016/j.wneu.2016.04.087 10.3171/foc.2003.14.3.4 10.1016/j.jocn.2009.08.010 10.1016/j.jstrokecerebrovasdis.2020.104957 10.1148/radiol.2018170509 10.1227/01.NEU.0000315873.41953.74 10.1016/S0303-8467(97)00082-6 10.1016/j.wneu.2019.01.089 10.1016/S0303-8467(97)00074-7 10.1227/01.NEU.0000336311.60660.26 10.4103/0028-3886.359200 10.1001/archneur.1969.00480090076012 10.4103/1793-5482.162681
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Keywords	Moya Moya disease AOS MMD MRI CBF HSV MCA Image processing algorithm ROI TIA mRS Single barrel bypass Perfusion analysis DSA Double barrel bypass ASL GUI STA-MCA Revascularization ACA
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Snippet	Moyamoya disease (MMD) is characterized by supraclinoid internal carotid artery narrowing causing cerebral parenchyma to starve. Direct and indirect...
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SubjectTerms	Double barrel bypass Image processing algorithm Moya Moya disease Perfusion analysis Revascularization Single barrel bypass
Title	Novel Method of Calculation of Magnetic Resonance Imaging Perfusion and Comparison of Single versus Double Barrel Superficial Temporal Artery-Middle Cerebral Artery Bypass for Revascularisation in Moya Moya Disease
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