Arterial spin-labeling MR imaging in Moyamoya disease compared with clinical assessments and other MR imaging findings

Abstract

Purpose: Our purpose was to identify the causal factors for the perfusion distribution obtained with ASL-MRI by comparing ASL-MRI with clinical information and other MRI findings in moyamoya disease.

Methods: Seventy-one patients with moyamoya disease underwent ASL-MRI and other MRI, including fluid-attenuated inversion recovery imaging (FLAIR) and three-dimensional time-of-flight magnetic resonance angiography (MRA) on 3.0-Tesla MRI system. Cerebral blood flow (CBF) values (ASL values) for the cerebral hemispheres (142 sides) were measured on CBF maps generated by ASL-MRI. Relationships between the ASL values and the following 9 factors were assessed: sex, family history, revascularization surgery, age at MR exam, age at onset, the steno-occlusive severity on MRA (MRA score), degree of basal collaterals, degree of leptomeningeal high signal intensity seen on FLAIR, and size of ischemic or hemorrhagic cerebrovascular accident lesion (CVA score).

Results: Patients with a family history had significantly higher ASL values than those without such a history. There were significant negative correlations between ASL values and age at MR exam, MRA score, and CVA score.

Conclusions: ASL-MRI may have cause-and-effect or mutual associations with family history, current patient age, size of CVA lesion, and intracranial arterial steno-occlusive severity in Moyamoya disease.

Keywords: 123I-IMP; A1; A2; ACA; AFA; ASL; Ambient segment of posterior cerebral artery; Arterial spin-labeling; BMV; C1; C2; CBF; CT; CVA; DSA; DSC-MRI; EPI; FLAIR; FOV; ICA; IR; M1; M2; MCA; MIP; MMD; MRA; MRI; Magnetic resonance angiography; Magnetic resonance imaging; Moyamoya disease; P2; PCA; PCoA; PET; POcA; Perfusion; Q2TIPS; ROI; SPECT; TE; TIA; TR; anterior cerebral artery; anterior falx artery; arterial spin-labeling; basal moyamoya vessel; cerebral blood flow; cerebrovascular accident; computed tomography; digital subtraction angiography; dynamic susceptibility contrast magnetic resonance imaging; echo time; echo-planar imaging; field of view; fluid-attenuated inversion recovery; horizontal segment of anterior cerebral artery; horizontal segment of middle cerebral artery; infracallosal segment of anterior cerebral artery; insular segment of middle cerebral artery; internal carotid artery; inversion recovery radiofrequency; iodine-123-N-Isopropyl-P-iodoamphetamine; magnetic resonance angiography; magnetic resonance imaging; maximum-intensity projection reconstruction; middle cerebral artery; moyamoya disease; parietooccipital artery; petrous segment of internal carotid artery; positron emission tomography; posterior cerebral artery; posterior communicating artery; posterior knee segment of distal internal carotid artery; region of interest; repetition time; single-photon emission computed tomography; the quantitative imaging of perfusion with thin-slice TI1 periodic saturation; transient ischemic attack.