{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:13:23Z","timestamp":1790417603072,"version":"4.1.0"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Cerebrovascular reserve (CVR) inversely correlates with stroke risk in children with Moyamoya disease and may be improved by revascularization surgery. We hypothesized that acetazolamide-challenged arterial spin labeling MR perfusion quantifies augmentation of CVR achieved by revascularization and correlates with currently accepted angiographic scoring criteria.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We retrospectively identified pediatric patients with Moyamoya disease or syndrome who received cerebral revascularization at \u226418 years of age between 2012 and 2019 at our institution. Using acetazolamide-challenged arterial spin labeling, we compared postoperative CVR to corresponding preoperative values and to postoperative perfusion outcomes classified by Matsushima grading.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              In this cohort, 32 patients (17 males) with Moyamoya underwent 29 direct and 16 indirect extracranial-intracranial bypasses at a median 9.7 years of age (interquartile range, 7.6\u201315.7). Following revascularization, median CVR increased within the ipsilateral middle cerebral artery territory (6.9 mL\/100 g per minute preoperatively versus 16.5 mL\/100 g per minute postoperatively,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). No differences were observed in the ipsilateral anterior cerebral artery (\n              <jats:italic>P<\/jats:italic>\n              =0.13) and posterior cerebral artery (\n              <jats:italic>P<\/jats:italic>\n              =0.48) territories. Postoperative CVR was higher in the ipsilateral middle cerebral artery territories of patients who achieved Matsushima grade A perfusion, in comparison to those with grades B or C (25.8 versus 17.5 mL,\n              <jats:italic>P<\/jats:italic>\n              =0.02). The method of bypass (direct or indirect) did not alter relative increases in CVR (8 versus 3.8 mL\/100 g per minute,\n              <jats:italic>P<\/jats:italic>\n              =0.7).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Acetazolamide-challenged arterial spin labeling noninvasively quantifies augmentation of CVR following surgery for Moyamoya disease and syndrome.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.036616","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T10:03:46Z","timestamp":1638785026000},"page":"1354-1362","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Acetazolamide-Challenged Arterial Spin Labeling Detects Augmented Cerebrovascular Reserve After Surgery for Moyamoya"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0822-0222","authenticated-orcid":true,"given":"Vaishnavi L.","family":"Rao","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine, CA (V.L.R., M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7737-8675","authenticated-orcid":true,"given":"Laura M.","family":"Prolo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (L.M.P., M.Z., J.L.Q., A.I., G.K.S., G.A.G.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-8234","authenticated-orcid":true,"given":"Jonathan D.","family":"Santoro","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, Children\u2019s Hospital Los Angeles, CA (J.D.S.)."},{"name":"Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles (J.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-0689","authenticated-orcid":true,"given":"Michael","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (L.M.P., M.Z., J.L.Q., A.I., G.K.S., G.A.G.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1202-5881","authenticated-orcid":true,"given":"Jennifer L.","family":"Quon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (L.M.P., M.Z., J.L.Q., A.I., G.K.S., G.A.G.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7709-1551","authenticated-orcid":true,"given":"Michael","family":"Jin","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, CA (V.L.R., M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (L.M.P., M.Z., J.L.Q., A.I., G.K.S., G.A.G.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2450-4014","authenticated-orcid":true,"given":"Vivek","family":"Yedavalli","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital, Department of Radiological Sciences, Baltimore, MD (V.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Lober","sequence":"additional","affiliation":[{"name":"Dayton Children\u2019s Hospital Division of Neurosurgery and Wright State University Boonshoft School of Medicine Department of Pediatrics, Dayton, OH 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