Novel Magnetic Resonance Angiography Stage Grading for Moyamoya Disease

Abstract

Background: Magnetic resonance angiography (MRA) has been acknowledged as a noninvasive diagnostic modality for moyamoya disease. However, in terms of staging of moyamoya disease, conventional angiography is still the gold standard. Therefore, the purpose of this study was to establish MRA grades for moyamoya disease as an alternative to conventional angiography. Methods: Twenty-two patients (44 sides) with moyamoya disease diagnosed by conventional angiography were evaluated by MRA during the past 5 years. MRA scores were assigned based on the severity of occlusive changes of the internal carotid artery, the horizontal portion of the middle cerebral artery, the anterior and the posterior cerebral arteries and the signals of the distal branches of these arteries. Total points ranged from 0 (normal) to 10 (most severe). Results: MRA scores (0–10) were significantly consistent with the conventional angiographic staging. Four grades based on this novel MRA scores correlated well with Suzuki’s stages, with high sensitivity and specificity. Conclusions: These novel MRA grades can be a reliable alternative to conventional staging. By employing these novel MRA grades, the use of conventional angiography can be avoided for the purpose of evaluation of the stages of moyamoya disease.

Changes in Integrity of Normal-Appearing White Matter in Patients with Moyamoya Disease: A Diffusion Tensor Imaging Study

“…with 3 years of experience in MR imaging interpretation and S.-K.L. with 13 years of experience) by visual analysis of the TTP map and by using the MRA scoring system proposed by Houkin et al 21 The rCBV patterns in the areas with more delayed TTP also were visually evaluated. ADC and FA values were measured in the bilateral centrum semiovale of both patient and control groups.…”

Noninvasive Evaluation of CBF and Perfusion Delay of Moyamoya Disease Using Arterial Spin-Labeling MRI with Multiple Postlabeling Delays: Comparison with15O-Gas PET and DSC-MRI

“…The details of the patient characteristics, including MRA scores and stages, 3,32 are listed in On-line Table 1.…”

Unilateral Hemispheric Proliferation of Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease Correlates Highly with Ipsilateral Hemispheric Decrease of Cerebrovascular Reserve

“…The correlation between hemispheric ivy proliferation and MRA images was studied according to the MRA grading system. 3,4 MRA scores of IDH and ILDH were compared. MRA scores were based on the severity of occlusive changes of the internal carotid artery, the horizontal portion of the middle cerebral artery (MCA), the anterior and the posterior cerebral arteries (ACAs and PCAs), and signals of the distal branches of these arteries.…”