{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:28:54Z","timestamp":1791919734889,"version":"4.3.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Cerebral blood flow (CBF) and transit time are essential biomarkers for assessing brain health. While dynamic susceptibility contrast (DSC) MRI has been widely applied to measure these metrics, it is limited in the pediatric population due to the need for contrast agents. Arterial spin labeling is a non-invasive and quantitative MR modality, and multi-delay ASL can measure CBF and transit time simultaneously. Although multi-delay ASL has been used in adult neuroimaging studies, its application in children requires investigation. Moyamoya disease, a progressive steno-occlusive cerebrovascular disorder, often manifests in childhood. In this work, we present a cohort study that examines multi-delay ASL and DSC MRI to characterize vascular hemodynamics in 22 pediatric patients. We evaluate CBF and transit time in different brain regions before and after revascularization surgeries. Results show that revascularization significantly increased CBF by 24% and 7.6%, respectively, as measured by ASL and DSC; it also significantly decreased transit time by 12% and 15%, indicating improved hemodynamics and metabolism. ASL and DSC results also showed significantly positive correlations in all brain regions. Thus, revascularization improved hemodynamics in pediatric moyamoya patients and shows that multi-delay ASL can effectively characterize CBF and transit time in the pediatric population.<\/jats:p>","DOI":"10.1177\/0271678x251358979","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T06:47:27Z","timestamp":1752648447000},"page":"2381-2392","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Characterizing pre- and post-operative cerebral blood flow and transit time in pediatric moyamoya patients using multi-delay ASL and DSC MRI"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0210-7739","authenticated-orcid":false,"given":"Moss Y","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Stanford Stroke Center, Stanford University, Stanford, CA, USA"},{"name":"Maternal and Child Health Research Institute, Stanford University, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Stanford Stroke Center, Stanford University, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris Antonio","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Stanford Stroke Center, Stanford University, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Zhang","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9884-3069","authenticated-orcid":false,"given":"Gabriella","family":"Morton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Stanford Stroke Center, Stanford University, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui Duarte","family":"Armindo","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen W","family":"Yeom","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Tong","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno P","family":"Soares","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8821-6636","authenticated-orcid":false,"given":"Sarah","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanford University, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9163-8741","authenticated-orcid":false,"given":"Michael","family":"Moseley","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6374-1058","authenticated-orcid":false,"given":"Gary K","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Stanford Stroke Center, Stanford University, Stanford, CA, USA"},{"name":"Department of Neurology, Stanford University, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X241245492"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2020.07.016"},{"key":"e_1_3_4_4_2","first-page":"1","article-title":"Short- and long-term outcomes of moyamoya patients post-revascularization","volume":"1","author":"Teo M","year":"2022","unstructured":"Teo M, Abhinav K, Bell-Stephens TE, et\u00a0al. Short- and long-term outcomes of moyamoya patients post-revascularization. J Neurosurg 2022; 1: 1\u201311.","journal-title":"J Neurosurg"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X221140343"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023426"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyz074"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12576-017-0525-0"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12666"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13408"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.10559"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156005"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.20460"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5945"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-80036-3"},{"key":"e_1_3_4_16_2","first-page":"e23625","article-title":"Role of magnetic resonance perfusion imaging in acute stroke: arterial spin labeling versus dynamic susceptibility contrast-enhanced perfusion","volume":"14","author":"Gopinath G","year":"2022","unstructured":"Gopinath G, Aslam M, Anusha P. Role of magnetic resonance perfusion imaging in acute stroke: arterial spin labeling versus dynamic susceptibility contrast-enhanced perfusion. Cureus 2022; 14: e23625.","journal-title":"Cureus"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-024-11315-0"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-022-05470-z"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.29572"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.25197"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.117246"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X221083471"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_3_4_24_2","first-page":"1156","volume-title":"Neurovascular surgery","author":"Steinberg GK","year":"2015","unstructured":"Steinberg GK, Gooderham PA. Intracranial-extracranial bypass surgery for moyamoya disease. In: Kalani Y, Nakaji P, Spetzler RF (eds) Neurovascular surgery. New York: Thieme, 2015, pp. 1156\u20131171."},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X17702156"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1162\/imag_a_00041"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28902"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.08.072"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.609008"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2004.07.051"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.021"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177730256"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.036616"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203568"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.07.020"},{"key":"e_1_3_4_36_2","first-page":"1842","article-title":"Comparison of CBF measured with combined velocity-selective arterial spin-labeling and pulsed arterial spin-labeling to blood flow patterns assessed by conventional angiography in pediatric moyamoya","volume":"40","author":"Bolar DS","year":"2019","unstructured":"Bolar DS, Gagoski B, Orbach DB, et\u00a0al. Comparison of CBF measured with combined velocity-selective arterial spin-labeling and pulsed arterial spin-labeling to blood flow patterns assessed by conventional angiography in pediatric moyamoya. AJNR Am J Neuroradiol 2019; 40: 1842\u20131849.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.29381"},{"key":"e_1_3_4_38_2","first-page":"296","article-title":"Principles of T2 *-weighted dynamic susceptibility contrast MRI technique in brain tumor imaging","volume":"00","author":"Shiroishi MS","year":"2014","unstructured":"Shiroishi MS, Castellazzi G, Boxerman JL, et\u00a0al. Principles of T2 *-weighted dynamic susceptibility contrast MRI technique in brain tumor imaging. J Magn Reson Imaging 2014; 00: 296\u2013313.","journal-title":"J Magn Reson Imaging"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.580670"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2023.0035"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.3171\/2009.1.FOCUS08300"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21255"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.29371"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804622"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei119"}],"container-title":["Journal of Cerebral Blood Flow &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X251358979","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0271678X251358979","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X251358979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:12:36Z","timestamp":1777493556000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0271678X251358979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":44,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/0271678X251358979"],"URL":"https:\/\/doi.org\/10.1177\/0271678x251358979","relation":{},"ISSN":["0271-678X","1559-7016"],"issn-type":[{"value":"0271-678X","type":"print"},{"value":"1559-7016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]}}}