{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:35:54Z","timestamp":1792730154744,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["5R01 NS097763"],"award-info":[{"award-number":["5R01 NS097763"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2022,10]]},"abstract":"\n Background<\/jats:title>\n Moyamoya is a progressive intracranial vasculopathy, primarily affecting distal segments of the internal carotid and middle cerebral arteries. Treatment may comprise angiogenesis\u2010inducing surgical revascularization; however, lack of randomized trials often results in subjective treatment decisions.<\/jats:p>\n <\/jats:sec>\n \n Hypothesis<\/jats:title>\n Compensatory presurgical posterior vertebrobasilar artery (VBA) flow\u2010territory reactivity, including greater cerebrovascular reactivity (CVR) and reduced vascular delay time, portends greater neoangiogenic response verified on digital subtraction angiography (DSA) at 1\u2010year follow\u2010up.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective intervention cohort.<\/jats:p>\n <\/jats:sec>\n \n Subjects<\/jats:title>\n Thirty\u2010one patients with moyamoya (26 females; age\u00a0=\u00a045\u00a0\u00b1\u200913\u2009years; 41 revascularized hemispheres).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Anatomical MRI, hypercapnic CVR MRI, and DSA acquired presurgically in adult moyamoya participants scheduled for clinically indicated surgical revascularization. One\u2010year postsurgery, DSA was repeated to evaluate collateralization.<\/jats:p>\n <\/jats:sec>\n \n Field Strength<\/jats:title>\n 3\u2009T.<\/jats:p>\n <\/jats:sec>\n \n Sequence<\/jats:title>\n \n Hypercapnic \u2010weighted gradient\u2010echo blood\u2010oxygenation\u2010level\u2010dependent,\n T<\/jats:italic>\n 2<\/jats:sub>\n \u2010weighted turbo\u2010spin\u2010echo fluid\u2010attenuated\u2010inversion\u2010recovery,\n T<\/jats:italic>\n 1<\/jats:sub>\n \u2010weighted magnetization\u2010prepared\u2010rapid\u2010gradient\u2010echo, and\n T<\/jats:italic>\n 2<\/jats:sub>\n \u2010weighted diffusion\u2010weighted\u2010imaging.\n <\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n Presurgical maximum CVR and response times were evaluated in VBA flow\u2010territories. Revascularization success was determined using an ordinal scoring system of neoangiogenic collateralization from postsurgical DSA by two cerebrovascular neurosurgeons (R.V.C. with 8\u2009years of experience; M.R.F. with 9\u2009years of experience) and one neuroradiologist (L.T.D. with 8\u2009years of experience). Stroke risk factors (age, sex, race, vasculopathy, and diabetes) were recorded.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Fisher's exact and Wilcoxon rank\u2010sum tests were applied to compare presurgical variables between cohorts with angiographically confirmed good (>1\/3 middle cerebral artery [MCA] territory revascularized) vs. poor (<1\/3 MCA territory revascularized) outcomes. Significance: two\u2010sided\n P<\/jats:italic>\n \u00a0<\u20090.05. Normalized odds ratios (ORs) were calculated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Criteria for good collateralization were met in 25 of the 41 revascularized hemispheres. Presurgical normalized VBA flow\u2010territory CVR was significantly higher in those with good (1.12\u2009\u00b1\u20090.13 unitless) vs. poor (1.04\u2009\u00b1\u20090.05 unitless) outcomes. Younger (OR\u00a0=\u00a0\u22120.60\u2009\u00b1\u20090.67) and White (OR\u00a0=\u00a0\u22121.81\u2009\u00b1\u20091.40) participants had highest revascularization success (good outcomes: age\u00a0=\u00a042\u2009\u00b1\u200914\u2009years, race\u00a0=\u00a084% White; poor outcomes: age\u00a0=\u00a049\u2009\u00b1\u200911\u2009years, race\u00a0=\u00a044% White).<\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n Presurgical MRI\u2010measures of VBA flow\u2010territory CVR are highest in moyamoya participants with better angiographic responses to surgical revascularization.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 1<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy Stage<\/jats:title>\n 4<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.28156","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T05:59:42Z","timestamp":1647323982000},"page":"983-994","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Presurgical Magnetic Resonance Imaging Indicators of Revascularization Response in Adults With Moyamoya Vasculopathy"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-9094","authenticated-orcid":false,"given":"Spencer","family":"L. Waddle","sequence":"first","affiliation":[{"name":"Department of Neurology Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Garza","sequence":"additional","affiliation":[{"name":"Department of Neurology Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry T.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"V. Chitale","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences Vanderbilt University Medical Center Nashville Tennessee USA"},{"name":"Department of Neurosurgery Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"R. Fusco","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences Vanderbilt University Medical Center Nashville Tennessee USA"},{"name":"Department of Neurosurgery Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"A. Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Vanderbilt University Medical Center Nashville Tennessee USA"},{"name":"Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niral J.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology Vanderbilt University Medical Center Nashville Tennessee USA"},{"name":"Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakmook","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department 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