Perfusion Quantification using Arterial Spin Labeling Magnetic Resonance Imaging after Revascularization for Moyamoya Disease

The hemodynamics in the brains of individuals with Moyamoya disease are complex and variable. Cerebral revascularization is an important treatment when hemodynamics are severely damaged. It's of great value to accurately quantify blood perfusion of different functional brain regions for better postoperative prognosis. In this study, we developed methods to segment territory of middle cerebral arteries (MCA) and its functional brain regions based on T1 and arterial spin labeling (ASL) imaging, absolute and normalized cerebral blood perfusion (CBF) were calculated for target regions-of-interest (ROI), spatial coefficient of variation was introduced to detect information of arterial transit time (ATT) contained in CBF images. After revascularization of Moyamoya disease, we detected perfusion improvement within MCA territory, while different alterations exist within different functional sub-regions. We also conformed that the spatial coefficient of variation of ASL CBF images can be used as an alternative ROI-based hemodynamic measurement to predict alterations of ATT. In summary, our methods show potential in postoperative evaluation of patients with Moyamoya disease.