Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya
The gold standard for evaluation of the severity of moyamoya vasculopathy is the Suzuki grade determined with cerebral catheter angiography (CA). With greater use of magnetic resonance angiography (MRA) it is important to understand if MRA is truly comparable to CA. Children with moyamoya were evalu...
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| Veröffentlicht in: | Pediatric neurology 2024-10, Vol.159, p.1-3 |
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| container_title | Pediatric neurology |
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| creator | Lehman, Laura L. Wu, Clara Kaseka, Matsanga-Leyila Muthusami, Prakash Armstrong, Derek Dirks, Peter Shroff, Manohar Moharir, Mahendranath Macgregor, Daune deVeber, Gabrielle Dlamini, Nomazulu |
| description | The gold standard for evaluation of the severity of moyamoya vasculopathy is the Suzuki grade determined with cerebral catheter angiography (CA). With greater use of magnetic resonance angiography (MRA) it is important to understand if MRA is truly comparable to CA.
Children with moyamoya were evaluated using the Suzuki score for CA and the modified MRA six-stage Suzuki score to describe the angiographic findings in moyamoya from initial narrowing of the distal internal carotid artery to the “puff of smoke” appearance of the lenticulostriate collaterals and finally to the disappearance of this network of collaterals. Using Cohen kappa we compared Suzuki grade based on CA with MRA in the same patients.
A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (P |
| doi_str_mv | 10.1016/j.pediatrneurol.2024.06.008 |
| format | Article |
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Children with moyamoya were evaluated using the Suzuki score for CA and the modified MRA six-stage Suzuki score to describe the angiographic findings in moyamoya from initial narrowing of the distal internal carotid artery to the “puff of smoke” appearance of the lenticulostriate collaterals and finally to the disappearance of this network of collaterals. Using Cohen kappa we compared Suzuki grade based on CA with MRA in the same patients.
A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (P < 0.0001), which is a moderate correlation.
We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.</description><identifier>ISSN: 0887-8994</identifier><identifier>ISSN: 1873-5150</identifier><identifier>EISSN: 1873-5150</identifier><identifier>DOI: 10.1016/j.pediatrneurol.2024.06.008</identifier><identifier>PMID: 39089182</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Cerebral Angiography ; Cerebral catheter angiogram ; Child ; Child, Preschool ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Moyamoya disease ; Moyamoya Disease - diagnostic imaging ; Moyamoya Disease - surgery ; Moyamoya syndrome ; MRA ; Pediatric moyamoya ; Retrospective Studies ; Severity of Illness Index</subject><ispartof>Pediatric neurology, 2024-10, Vol.159, p.1-3</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c255t-a8f357b98b08d8821f18f18c7ad2a46f3ece6ebdd4a3e79e9674f953449fcf053</cites><orcidid>0000-0002-6007-0356 ; 0000-0002-7062-9571 ; 0000-0001-5927-3132 ; 0000-0003-3315-6653 ; 0000-0002-9584-0576</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.pediatrneurol.2024.06.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39089182$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lehman, Laura L.</creatorcontrib><creatorcontrib>Wu, Clara</creatorcontrib><creatorcontrib>Kaseka, Matsanga-Leyila</creatorcontrib><creatorcontrib>Muthusami, Prakash</creatorcontrib><creatorcontrib>Armstrong, Derek</creatorcontrib><creatorcontrib>Dirks, Peter</creatorcontrib><creatorcontrib>Shroff, Manohar</creatorcontrib><creatorcontrib>Moharir, Mahendranath</creatorcontrib><creatorcontrib>Macgregor, Daune</creatorcontrib><creatorcontrib>deVeber, Gabrielle</creatorcontrib><creatorcontrib>Dlamini, Nomazulu</creatorcontrib><title>Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya</title><title>Pediatric neurology</title><addtitle>Pediatr Neurol</addtitle><description>The gold standard for evaluation of the severity of moyamoya vasculopathy is the Suzuki grade determined with cerebral catheter angiography (CA). With greater use of magnetic resonance angiography (MRA) it is important to understand if MRA is truly comparable to CA.
Children with moyamoya were evaluated using the Suzuki score for CA and the modified MRA six-stage Suzuki score to describe the angiographic findings in moyamoya from initial narrowing of the distal internal carotid artery to the “puff of smoke” appearance of the lenticulostriate collaterals and finally to the disappearance of this network of collaterals. Using Cohen kappa we compared Suzuki grade based on CA with MRA in the same patients.
A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (P < 0.0001), which is a moderate correlation.
We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.</description><subject>Adolescent</subject><subject>Cerebral Angiography</subject><subject>Cerebral catheter angiogram</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Moyamoya disease</subject><subject>Moyamoya Disease - diagnostic imaging</subject><subject>Moyamoya Disease - surgery</subject><subject>Moyamoya syndrome</subject><subject>MRA</subject><subject>Pediatric moyamoya</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><issn>0887-8994</issn><issn>1873-5150</issn><issn>1873-5150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEFvEzEQhS0EomnhLyBLXLjsYu_au7Y4RaHQSK2oCoij5djjjaONHexdpPx7HKUg9VZpRnN5783Mh9B7SmpKaPdxVx_Aej2lAHOKY92QhtWkqwkRL9CCir6tOOXkJVoQIfpKSMku0GXOO0IIlw17jS5aSYSkolmgdKeHAJM3-AFyDDoYwMsw-Dgkfdge8XKMAfA643XIs3PeeAgTdjHhz744Y_YZ62Dx9zkN3ugR3486BB8G7ANebf1oEwT8y09bfBePel_6DXrl9Jjh7eO8Qj-_XP9Y3VS3376uV8vbyjScT5UWruX9RooNEVaIhjoqSple20azzrVgoIONtUy30EuQXc-c5C1j0hlHeHuFPpxzDyn-niFPau-zgbEcCHHOqiUFFW-YZEX66Sw1KeacwKlD8nudjooSdYKuduoJdHWCrkinCvTifve4aN7swf73_qNcBNdnAZR3_3hIKp84mpKYwEzKRv-sRX8Bu66dJw</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Lehman, Laura L.</creator><creator>Wu, Clara</creator><creator>Kaseka, Matsanga-Leyila</creator><creator>Muthusami, Prakash</creator><creator>Armstrong, Derek</creator><creator>Dirks, Peter</creator><creator>Shroff, Manohar</creator><creator>Moharir, Mahendranath</creator><creator>Macgregor, Daune</creator><creator>deVeber, Gabrielle</creator><creator>Dlamini, Nomazulu</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6007-0356</orcidid><orcidid>https://orcid.org/0000-0002-7062-9571</orcidid><orcidid>https://orcid.org/0000-0001-5927-3132</orcidid><orcidid>https://orcid.org/0000-0003-3315-6653</orcidid><orcidid>https://orcid.org/0000-0002-9584-0576</orcidid></search><sort><creationdate>202410</creationdate><title>Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya</title><author>Lehman, Laura L. ; Wu, Clara ; Kaseka, Matsanga-Leyila ; Muthusami, Prakash ; Armstrong, Derek ; Dirks, Peter ; Shroff, Manohar ; Moharir, Mahendranath ; Macgregor, Daune ; deVeber, Gabrielle ; Dlamini, Nomazulu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c255t-a8f357b98b08d8821f18f18c7ad2a46f3ece6ebdd4a3e79e9674f953449fcf053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Cerebral Angiography</topic><topic>Cerebral catheter angiogram</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Moyamoya disease</topic><topic>Moyamoya Disease - diagnostic imaging</topic><topic>Moyamoya Disease - surgery</topic><topic>Moyamoya syndrome</topic><topic>MRA</topic><topic>Pediatric moyamoya</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lehman, Laura L.</creatorcontrib><creatorcontrib>Wu, Clara</creatorcontrib><creatorcontrib>Kaseka, Matsanga-Leyila</creatorcontrib><creatorcontrib>Muthusami, Prakash</creatorcontrib><creatorcontrib>Armstrong, Derek</creatorcontrib><creatorcontrib>Dirks, Peter</creatorcontrib><creatorcontrib>Shroff, Manohar</creatorcontrib><creatorcontrib>Moharir, Mahendranath</creatorcontrib><creatorcontrib>Macgregor, Daune</creatorcontrib><creatorcontrib>deVeber, Gabrielle</creatorcontrib><creatorcontrib>Dlamini, Nomazulu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lehman, Laura L.</au><au>Wu, Clara</au><au>Kaseka, Matsanga-Leyila</au><au>Muthusami, Prakash</au><au>Armstrong, Derek</au><au>Dirks, Peter</au><au>Shroff, Manohar</au><au>Moharir, Mahendranath</au><au>Macgregor, Daune</au><au>deVeber, Gabrielle</au><au>Dlamini, Nomazulu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya</atitle><jtitle>Pediatric neurology</jtitle><addtitle>Pediatr Neurol</addtitle><date>2024-10</date><risdate>2024</risdate><volume>159</volume><spage>1</spage><epage>3</epage><pages>1-3</pages><issn>0887-8994</issn><issn>1873-5150</issn><eissn>1873-5150</eissn><abstract>The gold standard for evaluation of the severity of moyamoya vasculopathy is the Suzuki grade determined with cerebral catheter angiography (CA). With greater use of magnetic resonance angiography (MRA) it is important to understand if MRA is truly comparable to CA.
Children with moyamoya were evaluated using the Suzuki score for CA and the modified MRA six-stage Suzuki score to describe the angiographic findings in moyamoya from initial narrowing of the distal internal carotid artery to the “puff of smoke” appearance of the lenticulostriate collaterals and finally to the disappearance of this network of collaterals. Using Cohen kappa we compared Suzuki grade based on CA with MRA in the same patients.
A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (P < 0.0001), which is a moderate correlation.
We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39089182</pmid><doi>10.1016/j.pediatrneurol.2024.06.008</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0002-6007-0356</orcidid><orcidid>https://orcid.org/0000-0002-7062-9571</orcidid><orcidid>https://orcid.org/0000-0001-5927-3132</orcidid><orcidid>https://orcid.org/0000-0003-3315-6653</orcidid><orcidid>https://orcid.org/0000-0002-9584-0576</orcidid></addata></record> |
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| subjects | Adolescent Cerebral Angiography Cerebral catheter angiogram Child Child, Preschool Female Humans Magnetic Resonance Angiography Male Moyamoya disease Moyamoya Disease - diagnostic imaging Moyamoya Disease - surgery Moyamoya syndrome MRA Pediatric moyamoya Retrospective Studies Severity of Illness Index |
| title | Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya |
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