{"title":"仅靠磁共振血管造影不足以诊断莫亚莫亚症儿童并制定手术计划","authors":"Laura L. Lehman MD, MPH , Clara Wu BS , Matsanga-Leyila Kaseka MD, MSc , Prakash Muthusami MD , Derek Armstrong MD , Peter Dirks MD, PhD , Manohar Shroff MD, DABR , Mahendranath Moharir MD, MSc , Daune Macgregor MD , Gabrielle deVeber MD, MSc , Nomazulu Dlamini MD, MSc, PhD","doi":"10.1016/j.pediatrneurol.2024.06.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (<em>P</em> < 0.0001), which is a moderate correlation.</p></div><div><h3>Conclusions</h3><p>We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.</p></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"159 ","pages":"Pages 1-3"},"PeriodicalIF":3.2000,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya\",\"authors\":\"Laura L. Lehman MD, MPH , Clara Wu BS , Matsanga-Leyila Kaseka MD, MSc , Prakash Muthusami MD , Derek Armstrong MD , Peter Dirks MD, PhD , Manohar Shroff MD, DABR , Mahendranath Moharir MD, MSc , Daune Macgregor MD , Gabrielle deVeber MD, MSc , Nomazulu Dlamini MD, MSc, PhD\",\"doi\":\"10.1016/j.pediatrneurol.2024.06.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>A total of 27 children with moyamoya were reviewed. We calculated a weighted Cohen kappa of 0.49 (<em>P</em> < 0.0001), which is a moderate correlation.</p></div><div><h3>Conclusions</h3><p>We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.</p></div>\",\"PeriodicalId\":19956,\"journal\":{\"name\":\"Pediatric neurology\",\"volume\":\"159 \",\"pages\":\"Pages 1-3\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0887899424002339\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric neurology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0887899424002339","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
评估莫亚莫亚血管病严重程度的金标准是通过脑导管血管造影（CA）确定的铃木分级。随着磁共振血管造影术（MRA）的应用越来越广泛，了解 MRA 是否能真正与 CA 相媲美显得尤为重要。我们使用 CA 的铃木评分和改良的 MRA 六阶段铃木评分对患有 moyamoya 的儿童进行了评估，以描述 moyamoya 的血管造影结果，从最初的远端颈内动脉狭窄到出现 "烟雾状 "的皮质袢，最后到袢网消失。我们使用科恩卡帕（Cohen kappa）比较了同一患者中基于 CA 和 MRA 的铃木分级。共对 27 名患有 moyamoya 的儿童进行了复查。我们计算出的加权科恩卡帕值为 0.49（< 0.0001），属于中度相关。我们建议在依赖 MRA 诊断和评估儿童莫亚莫亚症的严重程度时要谨慎。
Magnetic Resonance Angiography Alone Is Insufficient for Diagnosis and Surgical Planning in Children With Moyamoya
Background
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.
Methods
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.
Results
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.
Conclusions
We suggest caution in the reliance on MRA for the diagnosis and evaluation of severity of moyamoya in children.
期刊介绍：
Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system.
Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.
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