Added value of advanced perfusion parameters in Moyamoya patients - Case Study
Moyamoya disease (MMD) is a cerebrovascular disease characterised by progressive steno-occlusion of the terminal part of the internal carotid arteries, causing a decline in cerebral perfusion pressure (CPP) distal to the steno-occlusion lesion.
This will trigger a haemodynamic and metabolic response to preserve the cerebral metabolic rate of oxygen (CMRO2). Cerebral auto-regulation will dilate resistance arteries to maintain adequate cerebral blood flow, (decreasing the cerebrovascular reserve capacity (CVR) in affected vascular regions) and an increase in oxygen extraction fraction (OEF) will contribute to sufficient oxygenation and normal CMRO2.
CVR can be estimated measuring CBF during the Acetazolamide challenge using Arterial Spin Labelling. In this case report, advanced perfusion metrics OEFmax* and CMRO2max* were estimated based on DSC perfusion using Cercare Medical Neurosuite. This case report indicate the potential value of adding OEFmax and CMRO2max measurements in patients with MMD.
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