Magnetic resonance imaging characteristics of moyamoya disease

doi:10.3877/cma.j.issn.2095-655X.2019.04.003

Abstract

Abstract:

Objective

To explore the characteristics of brain magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in moyamoya disease.

Methods

The clinical and imaging data of 25 patients with moyamoya disease (MMD) from October 2014 to March 2019 in the Department of Pediatric, Neurology and Neurosurgery in Fengxian People′s Hospital were retrospectively analyzed. These patients underwent conventional 1.5 T MR with axial T1WI, T2WI, FLAIR, DWI, sagittal T2WI and 3D-TOF MRA. During the course of disease, all patients underwent CT plain scan, 15 patients underwent CT angiography (CTA) and 12 patients underwent digital subtraction angiography (DSA).

Results

MRI plain scan showed that the bilateral internal carotid artery ends, middle cerebral artery and anterior cerebral artery were thinned and the flow void was poor. The flow void signal of moyamoya vessels appeared on both sides of the skull base midline, which showed the best on axial T2WI. Point or strip-like high signal (ivy sign) distributed along the pia mater in both sides of the cerebral hemisphere on FLAIR images, mostly in the frontal and parietal lobes. Brush-like hyperintense signal (brush sign) on T2WI and FLAIR images could be seen in the radiation crown and semi-oval in 21 patients.Flow void of the basal ganglia could be seen on T2WI in 20 patients. Twenty-five patients with cerebral infarction (6 cases with fresh infarction) and 9 cases with old hemorrhage were diagnosed by MRI. MRA clearly showed different degrees of stenosis or occlusion in the end of bilateral internal carotid artery, anterior-middle cerebral artery and the abnormal vascular network at the skull base and high signal intensity areas of the bilateral basal ganglia on TOF source images.

Conclusion

MRI and MRA can show the characteristic vascular stenosis of moyamoya disease, its collateral circulation signs and the adverse results of stroke caused by moyamoya disease, which are worthy of application.

Key words: Moyamoya disease, Stroke, Magnetic resonance imaging, Magnetic resonance angiography, Diagnosis

Hui Luo, Changqing Ding, Yingying Sun, Ailan Ding. Magnetic resonance imaging characteristics of moyamoya disease[J]. Chinese Journal of Diagnostics(Electronic Edition), 2019, 07(04): 227-232.

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References 25

[1]	Kim JS. Moyamoya disease: epidemiology，clinical features，and diagnosis[J]．J Stroke，2016，18(1):2-11.
[2]	Li J, Jin M, Sun X，et al.Imaging of moyamoya disease and moyamoya syndrome：current status[J]．J Comput Assist Tomogr，2019，43(2):257-263.
[3]	孙文，刘文华，范进，等．烟雾病的磁共振成像[J]．国际脑血管病杂志，2010，18(7):513-517.
[4]	任斌，段炼.2012年烟雾病(Willis环自发性闭塞)诊断治疗指南(日本)的解读[J]．中国脑血管病杂志，2014，11(1):6-9.
[5]	Han Y, Qiao H, Chen S，et al.Intracranial artery stenosis magnetic resonance imaging aetiology and progression study：rationale and design[J]．Brain Behav，2018，8(12):e01154.
[6]	Fujimura M, Bang OY, Kim JS.Moyamoya disease[J]．Front Neurol Neurosci，2016(40):204-220.
[7]	Espert R, Gadea M, Alino M，et al.Moyamoya disease: clinical，neuroradiological，neuropsychological and genetic perspective[J]．Rev Neurol，2018，66(S1):s57-s64.
[8]	张晓红．烟雾病MRI结合MRA的诊断价值及临床误诊、漏诊原因分析[J]．中西医结合心脑血管病杂志，2017，15(2):242-243,256.
[9]	Muraoka S, Araki Y, Taoka T，et al.Prediction of intracranial arterial stenosis progression in patients with moyamoya vasculopathy：contrast-enhanced high-resolution magnetic resonance vessel wall imaging[J]．World Neurosurg，2018(116):e1114-e1121.
[10]	Yamamoto S, Kashiwazaki D, Akioka N，et al.Progressive shrinkage of involved arteries in parallel with disease progression in moyamoya disease[J]．World Neurosurg，2019(122):e253-e261.
[11]	王可颜，程敬亮，张勇，等．高分辨率MRI在鉴别烟雾病和动脉粥样硬化相关性烟雾综合征中的应用价值[J]．中华放射学杂志，2017，51(1):3-7.
[12]	黄显军，周志明，徐格林，等．烟雾病的常春藤征[J]．国际脑血管病杂志，2016，24(2):131-133.
[13]	Suzuki H, Mikami T, Kuribara T，et al.Pathophysiological consideration of medullary streaks on FLAIR imaging in pediatric moyamoya disease[J]．J Neurosurg Pediatr，2017，19(5):560-566.
[14]	Noshiro S, Mikami T, Komatsu K，et al.Cortical and subcortical vascular hypointensity on T2 weighted imaging in moyamoya disease[J]．Neurol Res，2016，38(2):110-116.
[15]	赵文卓，黄波涛，张得旺，等．MRI图像上"常春藤征"和"刷子征"对烟雾病的诊断价值[J]．现代医用影像学，2015，24(6):964-967.
[16]	Oh BH, Moon HC, Baek HM，et al.Comparison of 7T and 3T MRI in patients with moyamoya disease[J]．Magn Reson Imaging，2017(37):134-138.
[17]	Tamura G, Ihara S, Morota N．Reversible diffusion weighted imaging hyperintensities during the acute phase of ischemic stroke in pediatric moyamoya disease: a case report[J]．Childs Nerv Syst，2016，32(8):1531-1535.
[18]	Furtado SV, Medress ZA, Teo M，et al.Pathogenesis of aneurysms on major vessels in moyamoya disease and management outcome[J]．J Clin Neurosci，2019(61):219-224.
[19]	Su JB, Xi SD, Zhou SY，et al.Microstructural damage pattern of vascular cognitive impairment：a comparison between moyamoya disease and cerebrovascular atherosclerotic disease[J]．Neural Regen Res，2019，14(5):858-867.
[20]	Qiao PG, Zuo ZW, Han C，et al.Cortical thickness changes in adult moyamoya disease assessed by structural magnetic resonance imaging[J]．Clin Imaging，2017(46):71-77.
[21]	Togao O, Hiwatashi A, Obara M，et al.Acceleration-selective arterial spin-labeling MR angiography used to visualize distal cerebral arteries and collateral vessels in moyamoya disease[J]．Radiology，2018，286(2):611-621.
[22]	Taneja K, Lu H, Welch BG, et al. Evaluation of cerebrovascular reserve in patients with cerebrovascular diseases using resting-state MRI：a feasibility study[J]．Magn Reson Imaging，2019(59):46-52.
[23]	Sun W, Ruan Z, Dai X，et al.Quantifying hemodynamic changes in moyamoya disease based on two-dimensional cine phase-contrast magnetic resonance imaging and computational fluid dynamics[J]．World Neurosurg，2018(120):e1301-e1309.
[24]	王振，陈士跃，陈玉坤，等．高分辨率MRI管壁成像对成人烟雾病的评估[J]．影像诊断与介入放射学，2018，27(5):354-360.
[25]	谢光彤，丁长青，王雪璐，等．脑静脉窦血栓形成的影像学特征分析[J/CD]．中华诊断学电子杂志，2019，7(1):11-16.

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