Constructive interference in steady state imaging of moyamoya disease

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.