Demonstration of cerebral perfusion abnormalities in moyamoya disease using susceptibility perfusion- and diffusion-weighted MRI

Adams, William M.; Laitt, Roger; Li, K L; Jackson, Alan; Sherrington, C R; Talbot, P. R.

doi:10.1007/s002340050711

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…The confirmation of infarcts by diffusion-weighted imaging helped us to proceed with surgical management in a timely fashion. 10 Recently, Chabbert et al reported the use of diffusion-weighted imaging-MRI in two cases of childhood moyamoya disease for early detection of lesions and to monitor their progression.&dquo; In our serial neuroimaging, each new infarct was unambiguously recognized as hyperintense on diffusion-weighted imaging. Previous infarcts, readily detected on other MRI sequences, were not hyperintense on diffusion-weighted imaging.…”

Section: Discussionmentioning

confidence: 75%

Diffusion-Weighted Imaging in Moyamoya Disease

et al. 2001

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Moyamoya disease is characterized by progressive intracranial vascular stenoses of the circle of Willis, resulting in successive ischemic events. We report serial diffusion-weighted imaging studies in a case of moyamoya disease. A 4-year-old right-handed patient presented with multiple infarcts in the right and left hemispheres. Each new infarct was unambiguously recognized as bright on diffusion-weighted imaging. Previous infarcts, readily detected on other magnetic resonance imaging sequences, were not bright on diffusion-weighted imaging. The patient subsequently underwent bilateral synangiosis. In this case, the diffusion-weighted images were helpful in assessing the extent of infarcts, determining the age of the lesion, and correlation with new clinical findings. We emphasize the usefulness of diffusion-weighted imaging for following the clinical course of children with moyamoya disease, in whom new focal deficits are highly suspicious of new infarcts.

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Section: Discussionmentioning

confidence: 75%

Diffusion-Weighted Imaging in Moyamoya Disease

et al. 2001

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“…In case 2, initial DWI showed signal abnormality confined to the Sylvian fissure, and complete infarction was localized in the corona radiata, although SPECT showed decreased CBF in the entire middle cerebral artery region. We speculate that DWI may delineate regions reversible by re-perfusion of CBF, although a previous report suggested DWI lesions are usually larger than those on conventional MRI and SPECT in patients with moyamoya disease [7]. Patients with moyamoya disease can have repeated episodes of cerebral infarction.…”

Section: Discussionmentioning

confidence: 78%

The value of diffusion-weighted imaging in children with acute central nervous system symptoms

et al. 2015

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The value of diffusion-weighted imaging (DWI) in children with acute central nervous system (CNS) symptoms has not been fully established. We aimed to elucidate whether DWI gives additional information in children with acute CNS disorder. The subjects were eight children with acute CNS symptoms, whose cranial DWI showed signal abnormality. Two patients were suffered from cerebral infarction, and one had systemic lupus erythematosus with CNS involvement, four had acute encephalopathy, and one had relapsing encephalopathy. We retrospectively compared (1) the size of signal abnormality, (2) latency until appearance of signal abnormality, and (3) ability to differentiate old lesions between DWI and fluid-attenuation inversion recovery (FLAIR). In addition, we analyzed cerebral blood flow (CBF) changes in lesions detected by DWI, using single-photon emission computed topography (SPECT). In seven of eight patients, the size of signal abnormality was larger in DWI compared to FLAIR. In four of five patients with magnetic resonance imaging obtained during the very acute phase of CNS symptoms, the latency until appearance of signal abnormality was shorter on DWI compared to FLAIR. Combination of DWI and FLAIR successfully differentiated new lesions from old ones in all three subjects with a history of old lesions. DWI revealed signal abnormality not during the very acute phase but on 5th day of CNS symptoms in a patient with encephalopathy. In seven patients with SPECT available, lesions detected by DWI showed decreased CBF in four patients, increased CBF in two, normal CBF in one. DWI may provide useful additional information in children with acute CNS symptoms. Signal abnormalities on DWI may represent ischemic lesions or inflammatory lesions with increased or normal CBF on SPECT.

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“…Thus Yoon et al [17] thought that radionuclide or perfusion MR imaging may correlate well with clinical status. T 2 weighted perfusion MR imaging has been found to be effective in estimating cerebral haemodynamics in moyamoya disease [31][32][33][34]. These diagnostic maneuvers can be used to assess local hemodynamic changes after ICA-to-ECA bypass surgery [17,35,36].…”

Section: Evolution Of Diagnostic Proceduresmentioning

confidence: 99%

The Role of SPECT and MRI for Pre and Postoperative Evaluation of Childhood Moyamoya Disease: Case Report and Review of Literature

Biswas

Toyama²,

Imizu

et al. 2007

CMIR

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Moyamoya disease is a vascular disease of unknown aetiology characterized by chronic progressive stenosis leading to occlusion of the supraclinoid internal carotid arteries and the proximal anterior and middle cerebral arteries along with abundant collateral vessel formation. Clinically the disease manifests with features of cerebral ischaemia including recurrent TIA's, headache, seizures or motor deficits. Characteristic angiographic features on MR angiography and conventional angiography confirm diagnosis. However, as the presence of complete arterial occlusion on angiography does not reliably predict haemodynamic impairment, single photon emission computed tomography (SPECT) is indicated for quantitative assessment of regional cerebral blood flow. SPECT is thus employed to detect regional perfusion instability prior to treatment and to determine the extent of improvement of functional perfusion after treatment. Affected patients with recurrent or progressive cerebral ischemic episodes and haemodynamic deficits SPECT findings require surgical management aimed at improving blood supply to the hypoperfused ischaemic cortical regions. The most commonly suggested revascularization procedure for children is encephaloduroarteriosynangiosis (EDAS). We describe an illustrative case report of 7-year-old boy who presented with sudden-onset of left sided hemiparesis. Findings on CT, MRI and SPECT were consistent with a diagnosis of moyamoya disease with acute cerebral infarction. The boy underwent encephaloduroarteriosynangiosis twice with good outcome. Motor power in his left extremities improved from grade 1 to 3 without cognitive deficit. Postoperative MRI confirmed vascular patency while SPECT showed satisfactory cerebral perfusion consistent with his clinical outcome. We thus conclude that MRI and SPECT are invaluable tools in pre and postoperative evaluation of patients with moyamoya disease.

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Demonstration of cerebral perfusion abnormalities in moyamoya disease using susceptibility perfusion- and diffusion-weighted MRI

Cited by 11 publications

References 9 publications

Diffusion-Weighted Imaging in Moyamoya Disease

Diffusion-Weighted Imaging in Moyamoya Disease

The value of diffusion-weighted imaging in children with acute central nervous system symptoms

The Role of SPECT and MRI for Pre and Postoperative Evaluation of Childhood Moyamoya Disease: Case Report and Review of Literature

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