Moyamoya disease: evaluation with diffusion-weighted and perfusion echo-planar MR imaging

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Moyamoya disease is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries and the circle of Willis.
• Accurate assessment of regional cerebral perfusion is crucial for managing moyamoya disease and preventing ischemic events.

Purpose of the Study:

• To evaluate the clinical efficacy of diffusion-weighted and perfusion echo-planar magnetic resonance (MR) imaging in assessing moyamoya disease.
• To correlate MR imaging findings with conventional angiography in patients with moyamoya disease.

Main Methods:

• Prospective examination of 17 moyamoya disease patients using diffusion-weighted and perfusion echo-planar MR imaging.
• Calculation of delta R2* peak value, delta R2* peak time, and delta R2* integral to assess regional cerebral perfusion.
• Comparison of MR imaging findings with conventional angiography.

Main Results:

• Posterior cerebral artery (PCA) stenosis or occlusion was observed in 41% of PCAs.
• Significant decrease in delta R2* peak value ratio and significant increase in delta R2* peak time ratio were associated with PCA stenosis/occlusion.
• Increased frequency of cerebral infarctions in patients with stenotic or occlusive PCA lesions.
• Correlation found between decreased apparent diffusion coefficient and altered perfusion parameters in acute infarctions.

Conclusions:

• Regional cerebral perfusion is reduced and delayed in moyamoya disease, particularly with PCA stenosis and occlusion.
• Diffusion-weighted and perfusion MR imaging are valuable tools for evaluating cerebral ischemia in moyamoya disease.
• These imaging techniques aid in understanding the pathophysiology and clinical manifestations of moyamoya disease.