- Comparison of CBF Measured with Combined Velocity-Selective Arterial Spin-Labeling and Pulsed Arterial Spin-Labeling to Blood Flow Patterns Assessed by Conventional Angiography in Pediatric Moyamoya
This study assesses the accuracy of combined velocity-selective arterial spin-labeling and traditional pulsed arterial spin-labeling CBF measurements in pediatric Moyamoya disease, with comparison with blood flow patterns on conventional angiography. Twenty-two neurologically stable pediatric patients with Moyamoya disease and 5 asymptomatic siblings without frank Moyamoya disease were imaged with velocity-selective arterial spin-labeling, pulsed arterial spin-labeling, and DSA (patients). Qualitatively, velocity-selective arterial spin-labeling perfusion maps reflect the DSA parenchymal phase, regardless of postinjection timing. Conversely, pulsed arterial spin-labeling maps reflect the DSA appearance at postinjection times closer to pulsed arterial spin-labeling postlabeling delay, regardless of vascular phase. ASPECTS comparison showed excellent agreement between arterial spin-labeling and DSA, suggesting velocity-selective arterial spin-labeling and pulsed arterial spin-labeling capture key perfusion and transit delay information, respectively. Velocity-selective arterial spin-labeling offers a powerful approach to image perfusion in pediatric Moyamoya disease due to transit delay insensitivity.
- Board Certification Characteristics of Practicing Neuroradiologists
Of 3769 included radiologists ever subspecialty certified, 84.1% are currently subspecialty certified. Of 1777/3769 radiologists ever subspecialty-certified and with lifetime primary certificates, only 66.6% are currently subspecialty certified. Of 3341 included most-practice neuroradiologists (>50% clinical work effort in neuroradiology based on work relative value unit–weighted national Medicare claims), 73.0% were ever subspecialty certified; of these, 89.1% are currently subspecialty certified. More than one-quarter of most-practice neuroradiologists never obtained neuroradiology subspecialty certification. Even when initially obtained, that certification is commonly not maintained, particularly by lifetime primary certificate diplomates and those in nonacademic and smaller practices.
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