Asymptomatic microbleeds in moyamoya disease: T2*-weighted gradient-echo magnetic resonance imaging study

Kikuta, Ken-ichiro; Takagi, Yasushi; Nozaki, Kazuhiko; Hanakawa, Takashi; Okada, Tsutomu; Mikuni, Nobuhro; Miki, Yukio; Fushimi, Yasutaka; Yamamoto, Akira; Yamada, Keisuke; Fukuyama, Hidenao; Hashimoto, Nobuo

doi:10.3171/jns.2005.102.3.0470

Cited by 86 publications

(46 citation statements)

References 16 publications

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“…The incidence of MBs is reported as 14.8%-42%, depending on MR imaging quality such as 1.5T versus 3T or T2* versus SWI technique. [31][32][33] The significance of MBs in patients with an ischemic presentation is still controversial. Kikuta et al 32 reported MBs occurred with equal probability regardless of the MMD onset type (44% in hemorrhage versus 43% in ischemia).…”

Section: Patient Characteristics In Each Presentation Of MMDmentioning

confidence: 99%

“…[31][32][33] The significance of MBs in patients with an ischemic presentation is still controversial. Kikuta et al 32 reported MBs occurred with equal probability regardless of the MMD onset type (44% in hemorrhage versus 43% in ischemia). In contrast, Ishikawa et al 33 reported that patients with hemorrhage had more MBs than those with ischemia (33.3% in hemorrhage versus 11.1% in ischemia).…”

Section: Patient Characteristics In Each Presentation Of MMDmentioning

confidence: 99%

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“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

Horie¹,

Morikawa²,

Nozaki³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: SWI is a high spatial resolution MR imaging technique showing magnetic inhomogeneity that could demonstrate increased oxygen extraction in focal cerebral ischemia. The aim of this study was to investigate the characteristics in the signal intensity of DMVs by using SWI and to determine whether this method could indicate the severity of the hemodynamics in MMD by evaluating the correlation between SWI stage and hemodynamics on SPECT.

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Section: Patient Characteristics In Each Presentation Of MMDmentioning

confidence: 99%

Section: Patient Characteristics In Each Presentation Of MMDmentioning

confidence: 99%

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

Horie¹,

Morikawa²,

Nozaki³

et al. 2011

AJNR Am J Neuroradiol

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“…The definition of microbleeds also excludes hypointense foci located in areas of previous hemorrhage associated with hemorrhagic moyamoya disease. 9) Little is known about the histological character of microbleeds. 3) We treated a patient with moyamoya disease who underwent surgical resection of a microbleed and discuss the histological properties.…”

Section: Introductionmentioning

confidence: 99%

“…19) We previously reported the incidence of asymptomatic microbleeds in patients with moyamoya disease 4) as 43-44% regardless of the onset type, which is significantly higher than that in healthy individuals. 9) We defined asymptomatic microbleeds as hypointense foci of º10 mm in size detected by 3T T 2 *-weighted MR imaging. Vascular flow voids can be excluded by 3T MR angiography and hemorrhagic mass lesions such as cavernous angiomas by T 1 -and T 2 -weighterd MR imaging.…”

Section: Introductionmentioning

confidence: 99%

Histological Analysis of Microbleed After Surgical Resection in a Patient With Moyamoya Disease -Case Report-

Kikuta

Takagi

Nozaki

et al. 2007

Neurol. Med. Chir.(Tokyo)

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A 65-year-old male with moyamoya disease underwent surgical resection of a microbleed simultaneously with revascularization surgery. Histological examination identified several fragile arteries surrounding the microbleed. Microbleeds detected by T 2 *-weighted magnetic resonance imaging are considered to be a general marker of vascular vulnerability in cerebral angiopathy with a tendency to bleeding. The microbleeds observed in patients with moyamoya disease probably originate in bleeding from the fragile arteries.

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“…7,[10][11][12]20 Kikuta et al demonstrated a higher prevalence (44%) of cerebral microbleeds in patients with MMD than in healthy individuals (5.8%). 11 Our detection rate (8.1%) of microbleeds is the first reported in Korean patients with MMD and was rela- tively lower than those in the aforementioned studies. This might have been due to detection bias arising from the use of heterogeneous MR apparatuses and scanning protocols or ethnicity differences.…”

Section: Discussionmentioning

confidence: 99%

Association of apolipoprotein E gene polymorphism with small-vessel lesions and stroke type in moyamoya disease: a preliminary study

Jang

Huh

Lee

2016

JNS

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M oyaMoya disease (MMD) is a progressive cerebrovascular occlusive disorder consisting of bilateral stenosis or occlusion of the supraclinoid internal carotid artery (ICA) and its major branches, with net-like vessels in the area surrounding the circle of Willis. 27 Many studies have demonstrated a higher prevalence of asymptomatic cerebral microbleeds in patients with MMD compared with the normal population.11 In addition, a recent meta-analysis showed that a high incidence of asymptomatic cerebral microbleeds appeared to be correlated with the hemorrhagic onset type in patients with MMD.20 Kikuta et al. 12 identified the presence of multiple microbleeds as a predictor of subsequent hemorrhages in patients with MMD.abbreviatioNs APOE = apolipoprotein E; GRE = gradient-recalled echo; ICA = internal carotid artery; MMD = moyamoya disease; SVL = small-vessel lesion; T2WI = T2*-weighted imaging. obJective The present study was conducted to investigate whether microbleeds or microinfarcts are associated with apolipoprotein E (APOE) gene polymorphisms in patients with moyamoya disease (MMD), and if so, whether APOE gene polymorphisms are also associated with stroke type in patients with MMD. methods This cross-sectional, multicenter study included 86 consecutive patients with MMD who underwent T2*-weighted gradient echo or susceptibility-weighted MR imaging and 83 healthy control volunteers. Baseline clinical and radiological characteristics were recorded at diagnosis, and inter- and intragroup differences in the APOE genotypes were assessed. Multivariate binary logistic regression models were used to determine the association factors for smallvessel lesions (SVLs) and hemorrhagic presentation in patients with MMD. results There was no difference in APOE gene polymorphism and the incidence of SVLs between patients with MMD and healthy controls (p > 0.05). In the MMD group, 7 (8.1%) patients had microbleeds and 32 (37.2%) patients had microinfarcts. Microbleeds were more frequently identified in patients with hemorrhagic-type than in nonhemorrhagictype MMD (p = 0.003). APOE genotypes differed according to the presence of microbleeds (p = 0.024). APOE ε2 or ε4 carriers also experienced microbleeds more frequently than APOE ε3/ε3 carriers (p = 0.013). In the multivariate regression analysis in patients with MMD, microbleeds were significantly related to APOE ε2 or ε4 carrier status (OR 7.86;; p = 0.032) and cerebral aneurysm (OR 17.31; 95% CI 2.09-143.57; p = 0.008). Microinfarcts were independently associated with hypertension (OR 3.01; 95% CI 1.05-7.86; p = 0.007). Hemorrhagic presentation was markedly associated with microbleeds (OR 10.63; 95% CI 1.11-102.0; p = 0.041). coNclusioNs These preliminary results did not show a difference in APOE gene polymorphisms between patients with MMD and healthy persons. However, they imply that APOE gene polymorphisms may play certain roles in the presence of microbleeds but not microinfarcts in patients with MMD. A further confirmatory study is necessary to elucidate the effec...

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Asymptomatic microbleeds in moyamoya disease: T2*-weighted gradient-echo magnetic resonance imaging study

Abstract: Microbleeds are significantly more common in patients with MMD than in healthy individuals regardless of the disease type. The evaluation of MBs with T2*-weighted 3-tesla MR imaging might contribute to the treatment of MMD.

Cited by 86 publications

References 16 publications

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

Histological Analysis of Microbleed After Surgical Resection in a Patient With Moyamoya Disease -Case Report-

Association of apolipoprotein E gene polymorphism with small-vessel lesions and stroke type in moyamoya disease: a preliminary study

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