Vessel wall imaging features of Moyamoya disease in a North American population: patterns of negative remodelling, contrast enhancement, wall thickening, and stenosis

BMC Medical Imaging
Anthony S. Larson1, James P. Klaas2, Matthew P. Johnson3, John C. Benson4, Darya P. Shlapak4, Giuseppe Lanzino4, Luis Savastano5, Vance T. Lehman4
1University of Minnesota Medical School, Minneapolis MN, USA
2Department of Neurology, Mayo Clinic, Rochester, MN, USA
3Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
4Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
5Neurologic Surgery, Mayo Clinic, Rochester, MN, USA

Tóm tắt

Abstract Background This study characterized vessel wall imaging (VWI) features of Moyamoya disease (MMD) in a predominantly adult population at a North American center. Methods Consecutive patients with VWI were included. Twelve arterial segments were analyzed for wall thickening, degree and pattern of contrast enhancement, and remodeling. Results Overall, 286 segments were evaluated in 24 patients (mean age = 36.0 years [range = 1–58]). Of 172 affected segments, 163 (95%) demonstrated negative remodeling. Complete vessel wall obliteration was most frequent in the proximal M1 (17/48, 35%). Affected segments enhanced in 72/172 (42%) (n = 15 for grade II; n = 54 for concentric and n = 18 for eccentric); 20 of 24 (83%) patients had at least one enhancing segment. Both enhancing and non-enhancing segments were present in 19/20 (95%) patients. Vessel wall enhancement was most common in the proximal segments and correlated to the degree of stenosis (p < 0.001), and outer wall diameter (p < 0.001), but not disease duration (p = 0.922) or Suzuki score (p = 0.477). Wall thickening was present in 82/172 (48%) affected segments and was associated with contrast enhancement (p < 0.001), degree of stenosis (p < 0.001), and smaller outer wall diameter (p = 0.004). Conclusion This study presents VWI findings in North American patients with MMD. Negative remodeling was the most common finding. Most patients had both enhancing and non-enhancing abnormal segments. Vessel wall enhancement was most common in proximal segments, variable in pattern or degree and was correlated to the degree of stenosis and smaller outer wall diameter.

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Tài liệu tham khảo

Guey S, Tournier-Lasserve E, Herve D, Kossorotoff M. Moyamoya disease and syndromes: from genetics to clinical management. Appl Clin Genet. 2015;8:49–68.

Kundishora AJ, Peters ST, Pinard A, Duran D, Panchagnula S, Barak T, Miyagishima DF, Dong W, Smith H, Ocken J, et al. DIAPH1 variants in non-east asian patients with sporadic Moyamoya disease. JAMA Neurol. 2021;78(8):993–1003.

Song JW, Guiry SC, Shou H, Wang S, Witschey WR, Messe SR, Kasner SE, Loevner LA. Qualitative assessment and reporting quality of intracranial vessel wall MR imaging studies: a systematic review. AJNR Am J Neuroradiol. 2019;40(12):2025–32.

Lehman VT, Cogswell PM, Rinaldo L, Brinjikji W, Huston J, Klaas JP, Lanzino G. Contemporary and emerging magnetic resonance imaging methods for evaluation of Moyamoya disease. Neurosurg Focus. 2019;47(6):E6.

Research Committee on the Pathology and Treatment of Spontaneous Occlusion of the Circle of Willis. Health labour sciences research grant for research on measures for infractable diseases: guidelines for diagnosis and treatment of Moyamoya disease (spontaneous occlusion of the circle of Willis). Neurol Med Chir (Tokyo). 2012;52(5):245–266.

Kim DK, Verdoorn JT, Gunderson TM, Huston Iii J, Brinjikji W, Lanzino G, Lehman VT. Comparison of non-contrast vessel wall imaging and 3-D time-of-flight MRA for atherosclerotic stenosis and plaque characterization within intracranial arteries. J Neuroradiol. 2020;47(4):266–71.

Mossa-Basha M, de Havenon A, Becker KJ, Hallam DK, Levitt MR, Cohen WA, Hippe DS, Alexander MD, Tirschwell DL, Hatsukami T, et al. Added value of vessel wall magnetic resonance imaging in the differentiation of Moyamoya vasculopathies in a non-asian cohort. Stroke. 2016;47(7):1782–8.

Cogswell PM, Lants SK, Davis LT, Juttukonda MR, Fusco MR, Donahue MJ. Vessel wall and lumen features in north American Moyamoya patients. Clin Neuroradiol. 2020;30(3):545–52.

Kim YJ, Lee DH, Kwon JY, Kang DW, Suh DC, Kim JS, Kwon SU. High resolution MRI difference between Moyamoya disease and intracranial atherosclerosis. Eur J Neurol. 2013;20(9):1311–8.

Ryoo S, Cha J, Kim SJ, Choi JW, Ki CS, Kim KH, Jeon P, Kim JS, Hong SC, Bang OY. High-resolution magnetic resonance wall imaging findings of Moyamoya disease. Stroke. 2014;45(8):2457–60.

Yuan M, Liu ZQ, Wang ZQ, Li B, Xu LJ, Xiao XL. High-resolution MR imaging of the arterial wall in Moyamoya disease. Neurosci Lett. 2015;584:77–82.

Wang M, Yang Y, Zhou F, Li M, Liu R, Guan M, Li R, He L, Xu Y, Zhang B, et al. The contrast enhancement of intracranial arterial wall on high-resolution MRI and its clinical relevance in patients with Moyamoya vasculopathy. Sci Rep. 2017;7:44264.

Kaku Y, Morioka M, Ohmori Y, Kawano T, Kai Y, Fukuoka H, Hirai T, Yamashita Y, Kuratsu J. Outer-diameter narrowing of the internal carotid and middle cerebral arteries in Moyamoya disease detected on 3D constructive interference in steady-state MR image: is arterial constrictive remodeling a major pathogenesis? Acta Neurochir (Wien). 2012;154(12):2151–7.

Muraoka S, Araki Y, Taoka T, Kawai H, Okamoto S, Uda K, Ota S, Naganawa S, Wakabayashi T. Prediction of intracranial arterial stenosis progression in patients with Moyamoya vasculopathy: contrast-enhanced high-resolution magnetic resonance vessel wall imaging. World Neurosurg. 2018;116:e1114–21.

Kathuveetil A, Sylaja PN, Senthilvelan S, Kesavadas C, Banerjee M, Jayanand Sudhir B. Vessel wall thickening and enhancement in high-resolution intracranial vessel wall imaging: a predictor of future ischemic events in Moyamoya disease. AJNR Am J Neuroradiol. 2020;41(1):100–5.

Roder C, Hauser TK, Ernemann U, Tatagiba M, Khan N, Bender B. Arterial wall contrast enhancement in progressive Moyamoya disease. J Neurosurg. 2019;132(6):1845–53.

Yamashita M, Oka K, Tanaka K. Histopathology of the brain vascular network in Moyamoya disease. Stroke. 1983;14(1):50–8.

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