Meandering flow void around the splenium in moyamoya disease.

Area of Science:

• Neurology
• Radiology
• Vascular Imaging

Background:

• Moyamoya disease is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
• Collateral circulation, including flow voids around the splenium (SFVs), is a hallmark of moyamoya disease.
• Conventional T2-weighted MRI can visualize SFVs, suggesting their diagnostic potential.

Purpose of the Study:

• To evaluate the diagnostic value of SFVs in patients with moyamoya disease.
• To investigate the pathophysiology and clinical associations of SFVs.
• To establish a quantitative measure for SFV-based diagnosis.

Main Methods:

• A total of 65 moyamoya disease patients were analyzed, with SFV counts assessed bilaterally.
• SFV counts were compared between moyamoya disease patients, controls, and atherosclerotic disease patients.
• Receiver operating characteristic (ROC) curve analysis determined the diagnostic cut-off for SFVs.

Main Results:

• Moyamoya disease patients exhibited significantly higher mean SFV counts than control or atherosclerotic disease groups.
• An SFV count of 2.25 was identified as the optimal cut-off for diagnosing moyamoya disease via ROC analysis.
• Higher SFV counts correlated with increased age, basal ganglia flow voids, and poorer MRA scores.

Conclusions:

• The number of SFV curves on T2-weighted imaging is a valuable metric for confirming moyamoya disease diagnosis.
• An increased number of SFVs is associated with patient age and disease progression.
• SFV analysis offers a non-invasive method to support moyamoya disease diagnosis.