This Article Full Text Full Text (PDF) All Versions of this Article: 36/7/1485    most recent 01.STR.0000170709.95185.b1v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by So, Y. Articles by Lee, D. S. Search for Related Content PubMed PubMed Citation Articles by So, Y. Articles by Lee, D. S. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB ACETAZOLAMIDE Medline Plus Health Information Nuclear Scans Related Collections PET and SPECT Risk Factors for Stroke By-pass procedures

(Stroke. 2005;36:1485.)
© 2005 American Heart Association, Inc.

Original Contributions

Prediction of the Clinical Outcome of Pediatric Moyamoya Disease With Postoperative Basal/Acetazolamide Stress Brain Perfusion SPECT After Revascularization Surgery

Young So, MD; Ho-Young Lee, MD; Seung-Ki Kim, MD; Jae Sung Lee, PhD; Kyu-Chang Wang, MD; Byung-Kyu Cho, MD; Eunjoo Kang, PhD Dong Soo Lee, MD

From the Departments of Nuclear Medicine (Y.S., H.-Y.L., J.S.L., E.K., D.S.L.) and Neurosurgery (S.-K.K., K.-C.W., B.-K.C.), Seoul National University College of Medicine, Korea; and the Department of Nuclear Medicine, Konkuk University, College of Medicine (Y.S.), Seoul, Korea.

Correspondence to Dong Soo Lee, MD, Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong Chongno-gu Seoul 110-744, Korea. E-mail dsl{at}plaza.snu.ac.kr

Background and Purpose— We evaluated whether basal/acetazolamide stress brain perfusion SPECT performed after revascularization surgery can predict the further clinical outcome of patients with pediatric moyamoya disease.

Methods— A total of 77 (31 males, 46 females, age 6.6±3.2 years) patients with postoperative pediatric moyamoya disease who underwent basal/acetazolamide stress brain perfusion SPECT 6 to 12 months after revascularization surgery and who were followed-up >12 months after SPECT were included. Mean follow-up period after SPECT was 36±19 months. Sixty-two patients underwent bilateral ribbon encephaloduroarteriosynangiosis (EDAS), 14 bilateral EDAS, and 1 unilateral EDAS. Ordinal logistic regression analysis using 5 independent variables (infarction on preoperative MRI, age at the first operation, highest Suzuki stage on cerebral angiography, and regional cerebrovascular reserve on postoperative SPECT) against postoperative clinical outcomes was performed.

Results— Fifty-one patients had preserved reserve on postoperative SPECT and their clinical outcomes were excellent (30), good (15), fair (4), and poor (2); 26 patients had decreased reserve (excellent, 1; good, 7; fair, 14; poor, 4). On ordinal logistic regression analysis, age at the first operation (P=0.033) and reserve on postoperative SPECT (P<0.001) were statistically significant.

Conclusion— Basal/acetazolamide stress brain perfusion SPECT performed at 6 to 12 months after the indirect bypass operation could predict the further clinical outcome of pediatric patients with moyamoya disease. Patients with decreased cerebrovascular reserve will have remaining neurological deficit and ischemic attacks on follow-up.

Key Words: cerebral revascularization • moyamoya disease • outcome • tomography, emission, computed

This article has been cited by other articles:

				T. J. Yun, J.-E. Cheon, D. G. Na, W. S. Kim, I.-O. Kim, K.-H. Chang, K. M. Yeon, I. C. Song, and K.-C. Wang Childhood Moyamoya Disease: Quantitative Evaluation of Perfusion MR Imaging--Correlation with Clinical Outcome after Revascularization Surgery Radiology, April 1, 2009; 251(1): 216 - 223. [Abstract] [Full Text] [PDF]

				J-M Kim, S-H Lee, and J-K Roh Changing ischaemic lesion patterns in adult moyamoya disease J. Neurol. Neurosurg. Psychiatry, January 1, 2009; 80(1): 36 - 40. [Abstract] [Full Text] [PDF]