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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

Evaluation of Encephaloduroarteriosynangiosis Efficacy Using Probabilistic Independent Component Analysis Applied to Dynamic Susceptibility Contrast Perfusion MRI

A.N. Laiwalla, F. Kurth, K. Leu, R. Liou, J. Pamplona, Y.C. Ooi, N. Salamon, B.M. Ellingson and N.R. Gonzalez
American Journal of Neuroradiology March 2017, 38 (3) 507-514; DOI: https://doi.org/10.3174/ajnr.A5041
A.N. Laiwalla
aFrom the Departments of Neurosurgery (A.N.L., Y.C.O.)
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F. Kurth
cDepartment of Neurosurgery (F.K., R.L., N.R.G.), Cedars Sinai Medical Center, Los Angeles, California.
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K. Leu
bRadiology (K.L., J.P., N.S., B.M.E.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
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R. Liou
cDepartment of Neurosurgery (F.K., R.L., N.R.G.), Cedars Sinai Medical Center, Los Angeles, California.
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J. Pamplona
bRadiology (K.L., J.P., N.S., B.M.E.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
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Y.C. Ooi
aFrom the Departments of Neurosurgery (A.N.L., Y.C.O.)
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N. Salamon
bRadiology (K.L., J.P., N.S., B.M.E.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
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B.M. Ellingson
bRadiology (K.L., J.P., N.S., B.M.E.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
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N.R. Gonzalez
cDepartment of Neurosurgery (F.K., R.L., N.R.G.), Cedars Sinai Medical Center, Los Angeles, California.
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    Fig 1.

    Probabilistic independent component analysis of presurgical DSC-MR imaging of a patient undergoing EDAS. Probability maps of arterial (left) and venous (right) components are shown on an axial section. The respective time courses show a delayed response in the venous component. The color bar indicates local probability. Note the high probability for the venous component in the left hemispheric cortex, which is the symptomatic side.

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    Fig 2.

    Temporal changes in the mean local probability of the tissue to belong to either the arterial (red), venous (blue), or capillary (green) component. The dominance of the venous component at baseline in the symptomatic hemisphere indicates delayed perfusion. Note the normalization in dominance with time, suggesting an accelerated perfusion of the surgical region.

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    Fig 3.

    Comparison between the results from probabilistic ICA and the postoperative DSA studies in 2 sample patients. The results for the arterial and venous component are shown on the left, with the arterial component in red and the venous component in blue. The sagittal view of the respective postoperative DSA study is depicted directly to the right side of these graphs. Upper part: Note that this patient did not exhibit the pattern of an inversion of the probabilities as presented in Fig 2 for the whole sample. The respective postoperative DSA study does not show any new anastomoses between the donor artery and the intracranial vasculature. Lower part: This patient exhibited an inversion of the probabilities on the surgical side with a postoperative decrease of the venous component. The newly formed anastomoses with the intracranial arteries are indicated with a red arrow.

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    Table 1:

    Study participants—characteristics, history of TIA, and stroke and imaging data at the time of the first and last scan relative to the operation and the number of observations

    IDAge (yr)SexDiagnosisEvents Pre- and PostoperationImaging Data
    Pre-Post-Time Range (days)Time Points
    155FICASTIA−19–3735
    265FICASStrokeTIA−14–3644
    375FICASStroke107–3654
    466FICASTIA + Stroke99–3724
    563MICASStroke−14–3704
    655FMMDStroke−71–1723
    723FMMDStroke−4–942
    867MICASTIA−7–1902
    956FMMDTIA−7–1352
    1047FICASStroke−3–1863
    1170FICASTIA + Stroke−151
    1235FMMDTIA + Stroke1161
    1335FMMDTIA4371
    • Note:—ID indicates identification.

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    Table 2:

    Significance of the association between the time after the operation and the measurements of interest within the surgical side, the contralateral side, and their interaction

    P Interactionr Surgical SideP Surgical Sider Control SideP Control Side
    Artery.2580.024.418−0.109.194
    Vein.001a−0.426.002a0.051.281
    Capillary.009−0.332.020−0.003.489
    rCBF.270−0.017.444−0.116.226
    rCBV.4040.157.1210.113.192
    TTP.1200.181.1510.260.039
    • Note:—P indicates probability; r, correlation coefficient.

    • ↵a Significant results after correction for multiple comparisons using a Bonferroni correction.

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American Journal of Neuroradiology: 38 (3)
American Journal of Neuroradiology
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1 Mar 2017
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A.N. Laiwalla, F. Kurth, K. Leu, R. Liou, J. Pamplona, Y.C. Ooi, N. Salamon, B.M. Ellingson, N.R. Gonzalez
Evaluation of Encephaloduroarteriosynangiosis Efficacy Using Probabilistic Independent Component Analysis Applied to Dynamic Susceptibility Contrast Perfusion MRI
American Journal of Neuroradiology Mar 2017, 38 (3) 507-514; DOI: 10.3174/ajnr.A5041

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Evaluation of Encephaloduroarteriosynangiosis Efficacy Using Probabilistic Independent Component Analysis Applied to Dynamic Susceptibility Contrast Perfusion MRI
A.N. Laiwalla, F. Kurth, K. Leu, R. Liou, J. Pamplona, Y.C. Ooi, N. Salamon, B.M. Ellingson, N.R. Gonzalez
American Journal of Neuroradiology Mar 2017, 38 (3) 507-514; DOI: 10.3174/ajnr.A5041
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