Document Detail


Power Doppler imaging in detection of surgically induced indirect neoangiogenesis in adult moyamoya disease.
MedLine Citation:
PMID:  16304991     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Moyamoya is a rare, chronic disease that leads to the progressive narrowing and/or occlusion of the distal internal carotid and proximal cerebral arteries. Chronic cerebral ischemia ensues due to insufficient collateral blood supply. One potential treatment consists of the restoration of regional cerebral blood flow by direct or indirect revascularization surgery. The extent of neovascularization, especially in indirect procedures such as encephalomyosynangiosis (EMS), is currently evaluated with conventional angiography. Because this method is invasive and carries some risks, the authors investigated power Doppler imaging as an alternative noninvasive bedside procedure that can be used to assess surgically induced indirect revascularization in adult patients with moyamoya disease. METHODS: Twelve symptomatic patients with adult moyamoya disease (seven women and five men, mean age 38 +/- 17 years) underwent combined (direct and indirect) revascularization. They were then examined using conventional angiography and power Doppler imaging to assess the extent of revascularization within 120 days postsurgery. According to the number of intracranial vessels demonstrating opacification on conventional angiography and power Doppler imaging studies, EMS was graded as follows: 1, absent (0 vessels); 2, moderate (one-four vessels); and 3, extensive (> four vessels) for both methods. Examiners were blinded to the classification results for the procedure that they did not grade. All 24 hemispheres were examined. The visual grading of EMS revealed a highly significant agreement between conventional angiography and power Doppler imaging (Spearman rank coefficient, r = 0.92; p < 0.001) and there was 100% agreement of patency of the bypass between the direct and indirect methods. CONCLUSIONS: The authors found excellent agreement between the two methods. Therefore, power Doppler imaging is a valid noninvasive alternative to carotid artery angiography in evaluating direct and indirect revascularization.
Authors:
Fabienne Perren; Peter Horn; Peter Vajkoczy; Peter Schmiedek; Stephen Meairs
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  103     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-24     Completed Date:  2005-12-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  869-72     Citation Subset:  AIM; IM    
Affiliation:
Departments of Neurology and Neurosurgery, University of Heidelberg, Universitätsklinikum, Mannheim, Germany. fabienneperren@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Carotid Arteries / ultrasonography
Cerebral Angiography
Cerebral Revascularization*
Female
Humans
Male
Middle Aged
Moyamoya Disease / surgery*,  ultrasonography*
Neovascularization, Physiologic
Ultrasonography, Doppler, Color*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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