Localized 1H-MR spectroscopy in moyamoya disease before and after revascularization surgery.

Objective: To evaluate, using localized proton magnetic resonance spectroscopy ((1)H-MRS), the cerebral metabolic change apparent after revascularization surgery in patients with moyamoya disease.

Materials And Methods: Sixteen children with moyamoya disease and eight age-matched normal controls underwent MR imaging, MR angiography, conventional angiography, and (99m)Tc- ECD SPECT. Frontal white matter and the basal ganglia of both hemispheres were subjected to localized (1)H-MRS, and after revascularization surgery, four patients underwent follow-up (1)H-MRS.

Results: Decreased NAA/Cr ratios (1.35+/-0.14 in patients vs. 1.55+/-0.24 in controls) and Cho/Cr ratios (0.96+/-0.13 in patients vs. 1.10+/-0.11 in controls) were observed in frontal white matter. After revascularization surgery, NAA/Cr and Cho/Cr ratios in this region increased. In the basal ganglia, there is no abnormal metabolic ratios.

Conclusion: Localized (1)H-MRS revealed abnormal metabolic change in both hemispheres of children with moyamoya disease. Because of its non-invasive nature, (1)H-MRS is potentially useful for the preoperative evaluation of metabolic abnormalities and their postoperative monitoring.