Neuronal impairment of adult moyamoya disease detected by quantified proton MRS and comparison with cerebral perfusion by SPECT with tc-99m HM-PAO: a trial of clinical quantification of metabolites.

We evaluated neuronal impairment of adult moyamoya patients by proton magnetic resonance spectroscopy (MRS) and cerebral perfusion scintigraphy. After evaluating two methods for compensating relaxation times, we selected a long TR, short TE sequence to achieve better reproducibility. The cerebral blood flow (CBF) value was measured by scintigraphy following the method of quantification reported in the previous literature. N-acetyl aspartate (NAA) concentrations and CBFs value were decreased statistically (P < 0. 05) compared with those of the age-matched normal controls. However, the decreased rate of NAA concentration was changed more than the CBF value, and no linear correlation was found between the two values. We considered that the NAA concentration was not always correlated with that of the present cerebral perfusion. The NAA concentration showed a more dispersive distribution in patients than in controls, indicating a large individual variation in neuronal impairment. We concluded that proton MRS may provide useful information about neuronal impairment in individual patients. J. Magn. Reson Imaging 1999;10:124-129.