{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:04:28Z","timestamp":1792638268480,"version":"4.5.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T00:00:00Z","timestamp":1520467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"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":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2019,1]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Surgical revascularization is often performed in patients with moyamoya, however routine tools for efficacy evaluation are underdeveloped. The gold standard is digital subtraction angiography (DSA); however, DSA requires ionizing radiation and procedural risk, and therefore is suboptimal for routine surveillance of parenchymal health.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To determine whether parenchymal vascular compliance measures, obtained noninvasively using magnetic resonance imaging (MRI), provide surrogates to revascularization success by comparing measures with DSA before and after surgical revascularization.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n Twenty surgical hemispheres with DSA and MRI performed before and after revascularization were evaluated. Cerebrovascular reactivity (CVR)-weighted images were acquired using hypercapnic 3-Tesla gradient echo blood oxygenation level-dependent MRI. Standard and novel analysis algorithms were applied (i) to quantify relative CVR (rCVR\n RAW<\/jats:sub>\n ), and decompose this response into (ii) relative maximum CVR (rCVR\n MAX<\/jats:sub>\n ) and (iii) a surrogate measure of the time for parenchyma to respond maximally to the stimulus, CVR\n DELAY<\/jats:sub>\n . Measures between time points in patients with good and poor surgical outcomes based on DSA-visualized neoangiogenesis were contrasted (signed-rank test; significance: 2-sided\n P<\/jats:italic>\n \u00a0<\u00a0.050).\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n rCVR\n RAW<\/jats:sub>\n increases (\n P<\/jats:italic>\n \u00a0=\u00a0.010) and CVR\n DELAY<\/jats:sub>\n decreases (\n P<\/jats:italic>\n \u00a0=\u00a0.001) were observed pre- vs post-revascularization in hemispheres with DSA-confirmed collateral formation; no difference was found pre- vs post-revascularization in hemispheres with poor revascularization. No significant change in rCVR\n MAX<\/jats:sub>\n post-revascularization was observed in either group, or between any of the MRI measures, in the nonsurgical hemisphere.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Improvement in parenchymal compliance measures post-revascularization, primarily attributed to reductions in microvascular response time, is concurrent with collateral formation visualized on DSA, and may be useful for longitudinal monitoring of surgical outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyx635","type":"journal-article","created":{"date-parts":[[2017,12,26]],"date-time":"2017-12-26T07:18:48Z","timestamp":1514272728000},"page":"261-271","source":"Crossref","is-referenced-by-count":22,"title":["Clinical Use of Cerebrovascular Compliance Imaging to Evaluate Revascularization in Patients With Moyamoya"],"prefix":"10.1227","volume":"84","author":[{"given":"Jennifer M","family":"Watchmaker","sequence":"first","affiliation":[{"name":"Vanderbilt University of Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blaise deB","family":"Frederick","sequence":"additional","affiliation":[{"name":"Brain Imaging Center, McLean Hospital, Belmont, Massachusetts"},{"name":"Consolidated Department of Psychiatry, Harvard Medical School, Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R","family":"Fusco","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meher R","family":"Juttukonda","sequence":"additional","affiliation":[{"name":"Vanderbilt University of Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K","family":"Lants","sequence":"additional","affiliation":[{"name":"Vanderbilt University of Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard S","family":"Kirshner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manus J","family":"Donahue","sequence":"additional","affiliation":[{"name":"Vanderbilt University of Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,1]]},"reference":[{"issue":"12","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1056\/NEJMra0804622","article-title":"Moyamoya disease and moyamoya syndrome","volume":"360","author":"Scott","year":"2009","journal-title":"N Engl J Med"},{"issue":"6","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.3171\/2014.8.JNS132176","article-title":"Surgical outcomes following encephaloduroarteriosynangiosis in north american adults with moyamoya","volume":"121","author":"Agarwalla","year":"2014","journal-title":"J Neurosurg"},{"issue":"6","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1227\/NEU.0000000000000162","article-title":"Surgical outcomes and predictors of stroke in a north american white and african american moyamoya population","volume":"73","author":"Mallory","year":"2013","journal-title":"Neurosurgery"},{"issue":"6","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.3171\/2015.6.JNS151105","article-title":"Stroke prevention by direct revascularization for patients with adult-onset moyamoya disease presenting with ischemia","volume":"124","author":"Kim","year":"2016","journal-title":"J Neurosurg"},{"issue":"5","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"927","DOI":"10.3171\/2009.4.JNS081649","article-title":"Clinical outcome after 450 revascularization procedures for moyamoya disease. 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