Noninvasive assessment of revascularization in adult-onset moyamoya disease after bypass surgery using super-selective ASL perfusion

The purpose of this study was to evaluate whether super-selective ASL (SS-ASL) perfusion imaging could precisely visualize the revascularization area after bypass surgery in moyamoya disease, compared to digital subtracted angiography (DSA). Twenty-eight bypassed hemispheres of twenty-six patients in moyamoya disease underwent postoperative six months SS-ASL and DSA. Subjective image analysis of the revascularization area, as well as collateral grading, were performed. The agreement of the revascularization area was excellent (weighted kappa, 0.83), and agreement of collateral grading was good (weighted kappa, 0.722.) SS-ASL could evaluate revascularization territory precisely in the patient of moyamoya disease who underwent bypass surgery.