High resolution MRI difference between moyamoya disease and intracranial atherosclerosis
High resolution MRI difference between moyamoya disease and intracranial atherosclerosis
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DOI：
10.1111/ene.12202
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发表时间：
2013-09-01
影响因子：
5.1
通讯作者：
Kwon, S. U.
中科院分区：
文献类型：
--
作者：
Kim, Y. J.;Lee, D. H.;Kwon, S. U.
背景和目的：沿着颅内动脉粥样硬化性疾病（ICAD），烟雾病（MMD）是亚洲人大脑中动脉（MCA）闭塞的最常见原因。虽然他们有不同的血管壁病理，传统的血管造影评价方法不能很容易区分MMD从ICAD在某些情况下，如在年轻患者动脉粥样硬化的危险因素。高分辨率磁共振成像（HR-MRI）的结果为MMD和症状性ICAD的MCA的病变段进行了比较，以进一步阐明动脉壁changes.Methods的差异：血管造影证实的患者，12 MMD和20 ICAD，谁遭受了中风，由于MCA闭塞招募和接受HR-MRI。由两名独立的评价者以盲法分析HR-MRI显示的外径大小和其他狭窄血管壁特征，包括增强、偏心和其他病变模式。（32.92 +/- 11.08岁对51.85 +/- 11.97岁;平均值+/- SD），狭窄部分的外径较小（MMD为1.61 +/- 0.43 mm，ICAD为3.03 +/- 0.53 mm，P < 0.0001）。偏心性病变（MMD组12例中的3例与ICAD组20例中的19例，P < 0.0001）和病变区域的局灶性增强（MMD组7例中的2例对ICAD组17例中的13例，P = 0.061）在MMD病例中不太常见。我们的HR-MRI结果显示，MMD与较小的同心圆闭塞性病变有关，与症状性ICAD相比，这些病变很少增强，与以往病理报告结果一致。因此，HR-MRI可用于区分MMD和ICAD。
Background and purpose: Along with intracranial atherosclerotic disease (ICAD), moyamoya disease (MMD) is the most common cause of middle cerebral artery (MCA) occlusion in Asians. Although they have differing vascular wall pathologies, conventional angiographic evaluation methods cannot easily differentiate MMD from ICAD in certain situations, such as in young patients with atherosclerotic risk factors. High resolution magnetic resonance imaging (HR-MRI) findings for the diseased segments of MCAs in MMD and symptomatic ICAD were compared to further elucidate differences in arterial wall changes.Methods: Angiographically confirmed patients, 12 MMD and 20 ICAD, who suffered a stroke due to MCA occlusion were recruited and underwent HR-MRI. The size of the outer diameter and other stenotic vessel wall characteristics revealed by HR-MRI, including enhancement, eccentricity and other lesion patterns, were analyzed by two independent reviewers in a blind fashion.Results: MMD patients were younger than ICAD patients (32.92 +/- 11.08 years vs. 51.85 +/- 11.97 years; mean +/- SD) and displayed a smaller outer diameter in the stenotic portion (1.61 +/- 0.43 mm for MMD vs. 3.03 +/- 0.53 mm for ICAD, P < 0.0001). Eccentric lesions (three of 12 in MMD vs. 19 of 20 in ICAD, P < 0.0001) and focal enhancements in diseased areas (two of seven in MMD vs. 13 of 17 in ICAD, P = 0.061) were less common in MMD cases.Conclusions: Our HR-MRI findings show that MMD is associated with smaller, concentric occlusive lesions which are rarely enhanced compared with symptomatic ICAD, consistent with the results of previous pathological reports. HR-MRI may therefore have utility in differentiating MMD from ICAD.