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Constructive interference in steady state imaging of moyamoya disease
Masaki Komiyama1, Tomoya Ishiguro, Misao Nishikawa
1Department of Neurosurgery, Osaka City General Hospital, Osaka. komiyam@japan-mail.com
Abstract:
The diagnostic accuracy of three-dimensional constructive interference in steady state (CISS) magnetic resonance (MR) imaging was evaluated for the assessment of idiopathic moyamoya disease. Six consecutive patients underwent MR angiography, CISS imaging, and digital subtraction angiography. MR angiography and CISS imaging visualization of the steno-occlusive changes in the distal internal carotid arteries and the development of moyamoya vessels in the basal cistern were compared to the results obtained by digital subtraction angiography. MR angiography revealed the steno-occlusive changes correctly in nine and overestimated the changes in three of 12 hemispheres examined. CISS imaging showed the steno-occlusive changes defined as decreased caliber of the internal carotid artery correctly in two, underestimated the changes in nine, and overestimated the changes in one of the 12 hemispheres. MR angiography detected moyamoya vessels correctly in five and underestimated the vessels in seven of the 12 hemispheres. CISS imaging revealed the moyamoya vessels correctly in 10, underestimated the vessels in one, and overestimated the vessels in one of the 12 hemispheres. CISS imaging can supplement MR angiography in the non-invasive diagnosis of moyamoya disease, especially for the evaluation of moyamoya vessels.
Insights
Three-dimensional constructive interference in steady state (CISS) magnetic resonance (MR) imaging aids in diagnosing moyamoya disease. CISS MR imaging is particularly valuable for visualizing moyamoya vessels, complementing MR angiography.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Idiopathic moyamoya disease involves progressive stenosis of intracranial arteries.
- Accurate diagnosis is crucial for timely intervention and stroke prevention.
- Current imaging modalities have limitations in fully characterizing disease extent.
Purpose of the Study:
- To evaluate the diagnostic accuracy of three-dimensional constructive interference in steady state (CISS) magnetic resonance (MR) imaging.
- To compare CISS MR imaging with MR angiography and digital subtraction angiography for moyamoya disease assessment.
- To determine the utility of CISS MR imaging in visualizing steno-occlusive changes and moyamoya vessels.
Main Methods:
- Six consecutive patients with suspected moyamoya disease underwent MR angiography, CISS MR imaging, and digital subtraction angiography.
- Visualization of steno-occlusive changes in distal internal carotid arteries and moyamoya vessels in basal cisterns were analyzed.
- Comparison of findings from MR angiography and CISS MR imaging against digital subtraction angiography results.
Main Results:
- MR angiography correctly identified steno-occlusive changes in 9/12 hemispheres, overestimating in 3/12.
- CISS MR imaging correctly identified steno-occlusive changes in 2/12 hemispheres, underestimating in 9/12 and overestimating in 1/12.
- MR angiography detected moyamoya vessels in 5/12 hemispheres, underestimating in 7/12.
- CISS MR imaging detected moyamoya vessels in 10/12 hemispheres, underestimating in 1/12 and overestimating in 1/12.
Conclusions:
- CISS MR imaging demonstrates high accuracy in detecting moyamoya vessels.
- CISS MR imaging can supplement MR angiography for non-invasive diagnosis of moyamoya disease.
- CISS MR imaging is especially beneficial for evaluating the characteristic moyamoya vessels.