Diffusion-weighted imaging in moyamoya disease

T B Soman1, M Takeoka, E C Dooling

  • 1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. teestas@yahoo.com

Insights

Diffusion-weighted imaging (DWI) helps track new brain infarcts in children with moyamoya disease. DWI distinguishes acute lesions, aiding in monitoring disease progression and treatment effectiveness.

Area of Science:

  • Neurology
  • Radiology
  • Pediatric Neurology

Background:

  • Moyamoya disease involves progressive stenosis of intracranial arteries, leading to recurrent ischemic strokes.
  • Pediatric moyamoya disease presents with significant neurological deficits due to these ischemic events.

Observation:

  • Serial diffusion-weighted imaging (DWI) studies were performed on a 4-year-old patient with moyamoya disease and multiple hemispheric infarcts.
  • New infarcts appeared as hyperintense (bright) lesions on DWI, while older infarcts were not hyperintense on DWI.

Findings:

  • DWI effectively identified acute ischemic lesions, differentiating them from pre-existing infarcts.
  • The imaging modality aided in assessing the extent and age of brain infarcts.
  • Correlation between new DWI findings and clinical presentation was established.

Implications:

  • Diffusion-weighted imaging is a valuable tool for monitoring the clinical course of pediatric moyamoya disease.
  • DWI assists in the early detection of new infarcts, prompting timely clinical correlation and management adjustments.
  • This technique enhances the understanding and management of cerebrovascular disease in children.

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